Provider Demographics
NPI:1609198548
Name:HANSON, IVY G (PHARM D)
Entity type:Individual
Prefix:DR
First Name:IVY
Middle Name:G
Last Name:HANSON
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 E DAVID DR
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:NE
Mailing Address - Zip Code:68467-9459
Mailing Address - Country:US
Mailing Address - Phone:402-362-2092
Mailing Address - Fax:402-362-2962
Practice Address - Street 1:101 E DAVID DR
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:NE
Practice Address - Zip Code:68467-9459
Practice Address - Country:US
Practice Address - Phone:402-362-2092
Practice Address - Fax:402-362-2962
Is Sole Proprietor?:No
Enumeration Date:2010-02-19
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE10196183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist