Healthcare Provider Details

I. General information

NPI: 1316979404
Provider Name (Legal Business Name): DONNA C HANKLA ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 10/31/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 METKER TRL SUITE A
STANFORD KY
40484-1049
US

IV. Provider business mailing address

107 METKER TRL SUITE A
STANFORD KY
40484-1049
US

V. Phone/Fax

Practice location:
  • Phone: 606-365-8338
  • Fax: 696-365-8142
Mailing address:
  • Phone: 606-365-8338
  • Fax: 696-365-8142

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number1805P
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: