Healthcare Provider Details

I. General information

NPI: 1174431621
Provider Name (Legal Business Name): ISRAA HASAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12601 PFLUMM RD
OVERLAND PARK KS
66213-2303
US

IV. Provider business mailing address

12601 PFLUMM RD
OVERLAND PARK KS
66213-2303
US

V. Phone/Fax

Practice location:
  • Phone: 913-764-3471
  • Fax: 913-764-5098
Mailing address:
  • Phone: 913-764-3471
  • Fax: 913-764-5098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number1-118845
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: