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General NPI Number Information
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NPI Number | 1932423613
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Entity Type | Individual
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Provider Name | ELIZABETH CORAZZO HANSEN R.PH.
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Gender | Female
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Dates
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Enumeration Date | 03/24/2010
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Last Update Date | 03/24/2010
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Provider Practice Location Address
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Address Line | 136 STUTTS RD SUITE 1A
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City | MOORESVILLE
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State | NC
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Zip | 28117-6402
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Country | US
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Telephone | 704-799-0078
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Fax | 704-799-0063
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Provider Business Mailing Address
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Address Line | 136 STUTTS RD SUITE 1A
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City | MOORESVILLE
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State | NC
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Zip | 28117-6402
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Country | US
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Telephone | 704-799-0078
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Fax | 704-799-0063
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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 | 15374
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License Number State | NC
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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 | 9004
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS34588
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License Number State | FL
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