Healthcare Provider Details

I. General information

NPI: 1821448556
Provider Name (Legal Business Name): NADIA HANKERSON BS, MSN, RN, AGNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2016
Last Update Date: 06/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2450 N ORANGE BLOSSOM TRL
KISSIMMEE FL
34744-2316
US

IV. Provider business mailing address

502 VILLA PARK RD
POINCIANA FL
34759-6103
US

V. Phone/Fax

Practice location:
  • Phone: 407-846-4343
  • Fax:
Mailing address:
  • Phone: 305-815-8991
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberRN196134
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberARNP9274013
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: