Healthcare Provider Details

I. General information

NPI: 1356319156
Provider Name (Legal Business Name): JANET LYNN HANKINS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JANET L. AHNEMANN M.D.

II. Dates (important events)

Enumeration Date: 03/09/2006
Last Update Date: 08/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 COMMUNITY
CLINTON MO
64735
US

IV. Provider business mailing address

1602 N 2ND ST
CLINTON MO
64735-1192
US

V. Phone/Fax

Practice location:
  • Phone: 888-403-1071
  • Fax:
Mailing address:
  • Phone: 660-885-8171
  • Fax: 660-890-8491

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number104613
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: