MEDICARE: PATRICIA HANKINS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1033514732
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA HANKINS

Provider Business Mailing Address
First Line	:	373 EDGEWOOD TERRACE DR
Second Line	:
City	:	JACKSON
State	:	MS
Zip	:	39206-6217
Country	:	US
Telephone Number	:	769-233-8176
Fax Number	:	769-257-6764

Provider Business Practice Location Address
First Line	:	373 EDGEWOOD TERRACE DR
Second Line	:
City	:	JACKSON
State	:	MS
Zip	:	39206-6217
Country	:	US
Telephone Number	:	769-233-8176
Fax Number	:	769-257-6764

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2014
Last Update Date	:	10/24/2014

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