Provider Demographics
NPI:1063876803
Name:PANK, JANET (HCP)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:PANK
Suffix:
Gender:F
Credentials:HCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1208 E 57TH ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-5410
Mailing Address - Country:US
Mailing Address - Phone:605-274-0280
Mailing Address - Fax:
Practice Address - Street 1:1208 E 57TH ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-5410
Practice Address - Country:US
Practice Address - Phone:605-274-0280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-07
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD432H237700000X
IA074797237700000X
NE801237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist