Provider Demographics
NPI:1346893302
Name:HOKE, SHAWNA LEE (PTA)
Entity Type:Individual
Prefix:
First Name:SHAWNA
Middle Name:LEE
Last Name:HOKE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:SHAWNA
Other - Middle Name:LEE
Other - Last Name:HOKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SHAWNA LEE THACKER
Mailing Address - Street 1:4719 GRANT LINE RD
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-2218
Mailing Address - Country:US
Mailing Address - Phone:812-564-0479
Mailing Address - Fax:
Practice Address - Street 1:118 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-3323
Practice Address - Country:US
Practice Address - Phone:812-948-1311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-18
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN06003532A225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant