Provider Demographics
NPI:1275769564
Name:HANKINS, ELEANOR BRAVO (PT)
Entity Type:Individual
Prefix:
First Name:ELEANOR
Middle Name:BRAVO
Last Name:HANKINS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15506 KING CIR
Mailing Address - Street 2:
Mailing Address - City:BENNINGTON
Mailing Address - State:NE
Mailing Address - Zip Code:68007-1818
Mailing Address - Country:US
Mailing Address - Phone:402-871-4089
Mailing Address - Fax:
Practice Address - Street 1:15506 KING CIR
Practice Address - Street 2:
Practice Address - City:BENNINGTON
Practice Address - State:NE
Practice Address - Zip Code:68007-1818
Practice Address - Country:US
Practice Address - Phone:402-871-4089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-01
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1571225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist