Provider Demographics
NPI:1568630408
Name:LAURA HANKE ARNP LTD CO
Entity type:Organization
Organization Name:LAURA HANKE ARNP LTD CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:HANKE
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:772-794-1291
Mailing Address - Street 1:3805 PROMENADE WAY
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34982-6568
Mailing Address - Country:US
Mailing Address - Phone:772-794-1291
Mailing Address - Fax:772-794-4435
Practice Address - Street 1:3805 PROMENADE WAY
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34982-6568
Practice Address - Country:US
Practice Address - Phone:772-794-1291
Practice Address - Fax:772-794-4435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-13
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2831342363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL304614100Medicaid
FLK8542Medicare PIN