1194714998 NPI number — KRISTIE L HANKINS APRN

Table of content: KRISTIE L HANKINS APRN (NPI 1194714998)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194714998 NPI number — KRISTIE L HANKINS APRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HANKINS
Provider First Name:
KRISTIE
Provider Middle Name:
L
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
APRN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194714998
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/30/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 950202
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOUISVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40295-0202
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
502-272-5100
Provider Business Mailing Address Fax Number:
502-272-5116

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
210 E GRAY ST
Provider Second Line Business Practice Location Address:
SUITE 1002
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40202-3900
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-584-2029
Provider Business Practice Location Address Fax Number:
502-584-0873
Provider Enumeration Date:
10/14/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  71002014A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363L00000X , with the licence number: 3004786 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 102377 . This is a "SIHO - CTS/NCC" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 7100036910 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000057094T . This is a "HUMANA - CTS/NCC" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 3525756000 . This is a "PASSPORT ADVANTAGE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 50031858 . This is a "PASSPORT/PASSPORT ADVANTAGE - CTS/NCC" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 50019468 . This is a "PASSPORT" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 000000708287 . This is a "ANTHEM- CTS/NCC" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 5916882 . This is a "CIGNA - CTS/NCC" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 7100040610 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




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