Provider Demographics
NPI:1558012039
Name:HANKINS, CHEZELLA
Entity Type:Individual
Prefix:
First Name:CHEZELLA
Middle Name:
Last Name:HANKINS
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 1:344 SHERIDAN DR
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:DE
Mailing Address - Zip Code:19720-2161
Mailing Address - Country:US
Mailing Address - Phone:910-441-8107
Mailing Address - Fax:
Practice Address - Street 1:344 SHERIDAN DR
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:DE
Practice Address - Zip Code:19720-2161
Practice Address - Country:US
Practice Address - Phone:910-441-8107
Practice Address - Fax:302-907-2218
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-15
Last Update Date:2022-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEDENC0014343E376K00000X
NC492988376K00000X
MDA00188482376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide