Healthcare Provider Details

I. General information

NPI: 1588023006
Provider Name (Legal Business Name): NICOLE HANKINS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2016
Last Update Date: 05/07/2021
Certification Date: 05/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL CENTER DR
BIDDEFORD ME
04005-9422
US

IV. Provider business mailing address

68 S SERVICE RD SUITE 350
MELVILLE NY
11747-2354
US

V. Phone/Fax

Practice location:
  • Phone: 207-283-7042
  • Fax:
Mailing address:
  • Phone: 516-945-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number074691-23
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRNA2213019
License Number StateME
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberRN63924
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: