MEDICARE: KRISTEN PAIGE LANING HANSEN PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	03232960	OH

General Provider Information

NPI Number	:	1023445434
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTEN PAIGE LANING HANSEN PHARMD

Provider Business Mailing Address
First Line	:	6101 ANDREWS RD
Second Line	:
City	:	MENTOR ON THE LAKE
State	:	OH
Zip	:	44060-2864
Country	:	US
Telephone Number	:	440-209-8391
Fax Number	:

Provider Business Practice Location Address
First Line	:	6101 ANDREWS RD
Second Line	:
City	:	MENTOR ON THE LAKE
State	:	OH
Zip	:	44060-2864
Country	:	US
Telephone Number	:	440-209-8391
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/30/2013
Last Update Date	:	09/30/2013

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