MEDICARE: MELISSA HANSEN PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	20062	IA

General Provider Information

NPI Number	:	1255967279
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA HANSEN PHARMD

Provider Business Mailing Address
First Line	:	3101 FLOYD BLVD
Second Line	:
City	:	SIOUX CITY
State	:	IA
Zip	:	51108-1467
Country	:	US
Telephone Number	:	712-239-8913
Fax Number	:

Provider Business Practice Location Address
First Line	:	3101 FLOYD BLVD
Second Line	:
City	:	SIOUX CITY
State	:	IA
Zip	:	51108-1467
Country	:	US
Telephone Number	:	712-239-8913
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/21/2020
Last Update Date	:	03/21/2020

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Directions to “ MELISSA HANSEN PHARMD” Practice Location

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