MEDICARE: HANKS HEALTH AND WELLNESS, LLC

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	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1861103814
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HANKS HEALTH AND WELLNESS, LLC

Provider Business Mailing Address
First Line	:	19503 LAKE CHARLES HWY STE B
Second Line	:
City	:	DERIDDER
State	:	LA
Zip	:	70634-2313
Country	:	US
Telephone Number	:	337-918-0422
Fax Number	:	337-234-3484

Provider Business Practice Location Address
First Line	:	19503 LAKE CHARLES HWY STE B
Second Line	:
City	:	DERIDDER
State	:	LA
Zip	:	70634-2313
Country	:	US
Telephone Number	:	337-918-0422
Fax Number	:	337-404-1207

Authorized Official
Title or Position	:	PROVIDER
Name	:	SHANNON DALE HANKS
Credential	:
Telephone Number	:	337-764-3460

Provider Enumeration Date	:	12/12/2022
Last Update Date	:	02/09/2026

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