HANKINSON, JENNIFER LEE (MD)

Provider Demographics

• NPI: 1225158157
• Name: HANKINSON, JENNIFER LEE (MD)
• Entity Type: Individual
• Prefix: DR
• First Name: JENNIFER
• Middle Name: LEE
• Last Name: HANKINSON
• Gender: F
• Credentials: MD
• Other - Prefix: DR
• Other - First Name: JENNIFER
• Other - Middle Name: CHRISTINA
• Other - Last Name: LEE
• Other - Last Name Type: Other Name
• Other - Credentials: MD
• Mailing Address - Street 1: 10700 E. GEDDES AVE SUITE 200
• Mailing Address - Street 2: ATTN: CREDENTIALING
• Mailing Address - City: ENGLEWOOD
• Mailing Address - State: CO
• Mailing Address - Zip Code: 80112
• Mailing Address - Country: US
• Mailing Address - Phone: 303-761-9190
• Mailing Address - Fax: 720-874-4462
• Practice Address - Street 1: 10700 E. GEDDES AVE SUITE 200
• Practice Address - Street 2: ATTN: CREDENTIALING
• Practice Address - City: ENGLEWOOD
• Practice Address - State: CO
• Practice Address - Zip Code: 80112
• Practice Address - Country: US
• Practice Address - Phone: 303-761-9190
• Practice Address - Fax: 720-874-4462
• Is Sole Proprietor?: No
• Enumeration Date: 2007-04-02
• Last Update Date: 2019-08-15

Provider Licenses

State	License ID	Taxonomies
CO	49017	2085R0202X
HI	17636	2085R0202X
KS	04-36555	2085R0202X
NE	25779	2085R0202X
NY	238687-1	2085R0202X

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization
Yes	2085R0202X	Allopathic & Osteopathic Physicians	Radiology	Diagnostic Radiology

Provider Identifiers

State	Identifier ID	ID Type	Issuer
WI	100018078	Medicaid
UT	1225158157	Medicaid
NE	84-059792913	Medicaid
NE	10025709000	Medicaid
CA	1225158157	Medicaid
NE	84-089712600	Medicaid
MI	1225158157	Medicaid
CO	40957268	Medicaid
MT	1225158157	Medicaid
WY	1225158157	Medicaid
KS	KA3249041	Medicare PIN
WY	1225158157	Medicaid
KS	P01366591	Medicare Oscar/Certification
NE	NA1215063	Medicare PIN
CO	COA104440	Medicare PIN
MT	1225158157	Medicaid
KS	111257011	Medicare PIN
NE	NA2517009	Medicare PIN
NE	84-059792913	Medicaid
CO	40957268	Medicaid