MEDICARE: LAURA HANKE ARNP LTD CO

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	363LA2200X	Adult Health Nurse Practitioner	2831342	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568630408
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAURA HANKE ARNP LTD CO

Provider Business Mailing Address
First Line	:	3805 PROMENADE WAY
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34982-6568
Country	:	US
Telephone Number	:	772-794-1291
Fax Number	:	772-794-4435

Provider Business Practice Location Address
First Line	:	3805 PROMENADE WAY
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34982-6568
Country	:	US
Telephone Number	:	772-794-1291
Fax Number	:	772-794-4435

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	LAURA HANKE
Credential	:	ARNP
Telephone Number	:	772-794-1291

Provider Enumeration Date	:	02/13/2008
Last Update Date	:	03/06/2013

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