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NPI Code Detail

MEDICARE: JORDAN N. HANKINS

MEDICARE: JORDAN N. HANKINS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1972913903
Entity Type Code : Individual
Provider Name (Legal Business Name) : JORDAN N. HANKINS
Provider Business Mailing Address
First Line : 2020 PINTO LN
Second Line :
City : LAS VEGAS
State : NV
Zip : 89106-4019
Country : US
Telephone Number : 702-816-3658
Fax Number : 702-816-4337
Provider Business Practice Location Address
First Line : 2020 PINTO LN
Second Line :
City : LAS VEGAS
State : NV
Zip : 89106-4019
Country : US
Telephone Number : 702-816-3658
Fax Number : 702-816-4337
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/29/2014
Last Update Date : 04/29/2014

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