Provider Demographics
NPI:1093432296
Name:HANKES, HOLLY BETH
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:BETH
Last Name:HANKES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3880 144TH ST W
Mailing Address - Street 2:
Mailing Address - City:ROSEMOUNT
Mailing Address - State:MN
Mailing Address - Zip Code:55068-4049
Mailing Address - Country:US
Mailing Address - Phone:952-393-7396
Mailing Address - Fax:
Practice Address - Street 1:3880 144TH ST W
Practice Address - Street 2:
Practice Address - City:ROSEMOUNT
Practice Address - State:MN
Practice Address - Zip Code:55068-4049
Practice Address - Country:US
Practice Address - Phone:952-393-7396
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-27
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2244903163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency