Provider Demographics
NPI:1356976328
Name:HANNA, KIROLLOS SAMIR (PHARMD, BCPS, BCOP)
Entity type:Individual
Prefix:DR
First Name:KIROLLOS
Middle Name:SAMIR
Last Name:HANNA
Suffix:
Gender:M
Credentials:PHARMD, BCPS, BCOP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 RAPP FARM BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH OAKS
Mailing Address - State:MN
Mailing Address - Zip Code:55127-4201
Mailing Address - Country:US
Mailing Address - Phone:615-481-9433
Mailing Address - Fax:
Practice Address - Street 1:14500 99TH AVE N, SUITE 0A030
Practice Address - Street 2:
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55369
Practice Address - Country:US
Practice Address - Phone:763-898-1822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-10
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1227181835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology