Healthcare Provider Details

I. General information

NPI: 1457110124
Provider Name (Legal Business Name): LAURA ELIZABETH HANSON PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/15/2024
Last Update Date: 03/15/2024
Certification Date: 03/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3228 W HORIZON DR
PHOENIX AZ
85086-4354
US

IV. Provider business mailing address

3228 W HORIZON DR
PHOENIX AZ
85086-4354
US

V. Phone/Fax

Practice location:
  • Phone: 602-809-9798
  • Fax:
Mailing address:
  • Phone: 602-809-9798
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License NumberS018198
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: