Provider Demographics
NPI:1205827631
Name:HANKES, CINDY B (MD)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:B
Last Name:HANKES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 E DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:FOND DU LAC
Mailing Address - State:WI
Mailing Address - Zip Code:54935-4560
Mailing Address - Country:US
Mailing Address - Phone:920-926-8340
Mailing Address - Fax:
Practice Address - Street 1:703 STATE ST
Practice Address - Street 2:
Practice Address - City:FOX LAKE
Practice Address - State:WI
Practice Address - Zip Code:53933-9550
Practice Address - Country:US
Practice Address - Phone:920-928-6300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1153363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI12978OtherDEAN
WI43875000Medicaid
WIWI01L9OtherJOHN DEERE
WI1003800OtherTOUCHPOINT
WI500020856OtherRAILROAD MEDICARE
WI390807236A8OtherUNITY
WI43875000Medicaid
WIWI01L9OtherJOHN DEERE
WI003316130Medicare ID - Type Unspecified