Healthcare Provider Details

I. General information

NPI: 1275710717
Provider Name (Legal Business Name): DIANA MARIE HANKEY UNDERWOOD WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DIANA MARIE HANKEY WHNP-BC

II. Dates (important events)

Enumeration Date: 01/28/2008
Last Update Date: 09/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3007 MEMORIAL PKWY SW
HUNTSVILLE AL
35801-5393
US

IV. Provider business mailing address

2508 RILEYS PASS SE
HUNTSVILLE AL
35803-2975
US

V. Phone/Fax

Practice location:
  • Phone: 256-799-2500
  • Fax:
Mailing address:
  • Phone: 256-270-9493
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1115553
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: