Provider Demographics
NPI:1710542089
Name:COUETTE, HANNAH KIRSTEN (PHARMD)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:KIRSTEN
Last Name:COUETTE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:KIRSTEN
Other - Last Name:FLACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:110 1ST ST S STE D
Mailing Address - Street 2:
Mailing Address - City:SAUK RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:56379-1404
Mailing Address - Country:US
Mailing Address - Phone:320-258-7111
Mailing Address - Fax:
Practice Address - Street 1:110 1ST ST S STE D
Practice Address - Street 2:
Practice Address - City:SAUK RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:56379-1404
Practice Address - Country:US
Practice Address - Phone:320-258-7111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-02
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN123909183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist