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General NPI Number Information
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NPI Number | 1629629423
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Entity Type | Individual
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Provider Name | STEPHANIE KAREN HANSON PHARMD
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Gender | Female
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Dates
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Enumeration Date | 09/23/2019
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Last Update Date | 02/28/2022
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Provider Practice Location Address
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Address Line | 63802 US HIGHWAY 93 STE B
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City | RONAN
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State | MT
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Zip | 59864-3414
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Country | US
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Telephone | 406-676-5600
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Fax | 406-676-5632
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Provider Business Mailing Address
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Address Line | 2701 CORRECTIONVILLE RD
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City | SIOUX CITY
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State | IA
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Zip | 51105-3627
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Country | US
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Telephone | 712-258-0113
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Fax | 712-258-0351
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 23179
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 83287
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License Number State | MT
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