Provider Demographics
NPI:1104884691
Name:HANKS, CATHERINE C (FNP)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:C
Last Name:HANKS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 W MORRIS BLVD
Mailing Address - Street 2:HEALTHSTAR PHYSICIANS SUITE 400B
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37813-2283
Mailing Address - Country:US
Mailing Address - Phone:423-581-1026
Mailing Address - Fax:423-318-2200
Practice Address - Street 1:420 W MORRIS BLVD
Practice Address - Street 2:HEALTHSTAR PHYSICIANS SUITE 400B
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37813-2283
Practice Address - Country:US
Practice Address - Phone:423-581-1026
Practice Address - Fax:423-318-2200
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN5638363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNTN0130OtherJOHN DEERE HEALTHCARE
TN3643228Medicaid
TN3643228Medicare PIN
TN36432283Medicare PIN
TNTN0130OtherJOHN DEERE HEALTHCARE
TNQ70014Medicare UPIN
TN3643228Medicaid