Provider Demographics
NPI:1194714998
Name:HANKINS, KRISTIE L (APRN)
Entity type:Individual
Prefix:
First Name:KRISTIE
Middle Name:L
Last Name:HANKINS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 950202
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40295-0202
Mailing Address - Country:US
Mailing Address - Phone:502-272-5100
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:210 E GRAY ST
Practice Address - Street 2:SUITE 1002
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-3900
Practice Address - Country:US
Practice Address - Phone:502-584-2029
Practice Address - Fax:502-584-0873
Is Sole Proprietor?:No
Enumeration Date:2005-10-14
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71002014A363L00000X
KY3004786363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY102377OtherSIHO - CTS/NCC
KY7100036910Medicaid
KY000057094TOtherHUMANA - CTS/NCC
KY3525756000OtherPASSPORT ADVANTAGE
KY50031858OtherPASSPORT/PASSPORT ADVANTAGE - CTS/NCC
KY50019468OtherPASSPORT
KY000000708287OtherANTHEM- CTS/NCC
KY5916882OtherCIGNA - CTS/NCC
KY7100040610Medicaid
KY3525756000OtherPASSPORT ADVANTAGE
KY0231409Medicare PIN
IN890680HMedicare PIN
INM400024007Medicare PIN
KY7100036910Medicaid