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NPI Code Detail

MEDICARE: DR. CONNIE SUNJU HANSEN PHARMD

MEDICARE:  DR. CONNIE SUNJU 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
1183500000XPharmacist10497258-1701UT

General Provider Information

NPI Number : 1972256436
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CONNIE SUNJU HANSEN PHARMD
Provider Business Mailing Address
First Line : 500 FOOTHILL BLVD
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84148-0001
Country : US
Telephone Number : 801-582-1565
Fax Number :
Provider Business Practice Location Address
First Line : 500 FOOTHILL BLVD
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84148-0001
Country : US
Telephone Number : 801-582-1565
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2022
Last Update Date : 05/15/2026

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