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General NPI Number Information
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NPI Number | 1568630408
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Entity Type | Organization
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Legal Business Name | LAURA HANKE ARNP LTD CO
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Dates
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Enumeration Date | 02/13/2008
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Last Update Date | 03/06/2013
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Provider Practice Location Address
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Address Line | 3805 PROMENADE WAY
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City | FORT PIERCE
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State | FL
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Zip | 34982-6568
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Country | US
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Telephone | 772-794-1291
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Fax | 772-794-4435
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Provider Business Mailing Address
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Address Line | 3805 PROMENADE WAY
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City | FORT PIERCE
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State | FL
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Zip | 34982-6568
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Country | US
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Telephone | 772-794-1291
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Fax | 772-794-4435
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | LAURA HANKE
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Credential | ARNP
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Telephone | 772-794-1291
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 2831342
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License Number State | FL
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