Healthcare Provider Details

I. General information

NPI: 1033396189
Provider Name (Legal Business Name): TEENA M HANSON PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2008
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 S BROADWAY
MINOT ND
58701-7420
US

IV. Provider business mailing address

3400 S BROADWAY
MINOT ND
58701-7420
US

V. Phone/Fax

Practice location:
  • Phone: 701-418-2600
  • Fax: 701-418-1090
Mailing address:
  • Phone: 701-418-2600
  • Fax: 701-418-1090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number4880
License Number StateND
# 2
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number10207
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: