Connor Hanson, RPH
Individual provider Active NPI Pharmacist · Ripon, WI
NPI 1396292736 · NPPES record last updated Sep 1, 2016
Key facts
- NPI
- 1396292736
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- #18341-40 (WI)
- Practice address
- 328 Watson St
Ripon, WI 54971-1517 - Phone
- (920) 748-5174
- NPI assigned
- Sep 1, 2016
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| #18341-40 | WI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ripon Drug Management Enterprises Inc | Past |
Accepting new patients | |
| Ripon Drug Management Enterprises Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | #18341-40 | WI | Yes |
Addresses
Primary practice location
328 Watson St
Ripon, WI 54971-1517
Mailing address
328 Watson St
Ripon, WI 54971-1517
Phone (920) 748-5174
Other providers in Ripon, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 1, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.