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NPI Code Detail

MEDICARE: CAROL HANEWINCKEL RN

MEDICARE: CAROL HANEWINCKEL RN
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
1163W00000XRegistered Nurse226251GA

General Provider Information

NPI Number : 1497158786
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROL HANEWINCKEL RN
Provider Business Mailing Address
First Line : 150 SCRANTON CONNECTOR
Second Line :
City : BRUNSWICK
State : GA
Zip : 31525-0540
Country : US
Telephone Number : 912-356-2158
Fax Number :
Provider Business Practice Location Address
First Line : 150 SCRANTON CONNECTOR
Second Line :
City : BRUNSWICK
State : GA
Zip : 31525-0540
Country : US
Telephone Number : 912-356-2158
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/01/2014
Last Update Date : 10/01/2014

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