Provider Demographics
NPI:1285970624
Name:HOENKE, INGRID ANNA (RD, PA-C)
Entity type:Individual
Prefix:MISS
First Name:INGRID
Middle Name:ANNA
Last Name:HOENKE
Suffix:
Gender:F
Credentials:RD, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 MIDDLE ISLAND POINT RD
Mailing Address - Street 2:
Mailing Address - City:MARQUETTE
Mailing Address - State:MI
Mailing Address - Zip Code:49855-9726
Mailing Address - Country:US
Mailing Address - Phone:906-360-3606
Mailing Address - Fax:
Practice Address - Street 1:6 MIDDLE ISLAND POINT RD
Practice Address - Street 2:
Practice Address - City:MARQUETTE
Practice Address - State:MI
Practice Address - Zip Code:49855-9726
Practice Address - Country:US
Practice Address - Phone:906-360-3606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-12
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1065603133V00000X
MI363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered