Provider Demographics
NPI:1619392859
Name:HANKINS, COLLEEN A (LPN)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:A
Last Name:HANKINS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:OH
Mailing Address - Zip Code:43420-1132
Mailing Address - Country:US
Mailing Address - Phone:419-334-5469
Mailing Address - Fax:419-334-5450
Practice Address - Street 1:1100 NORTH ST
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:OH
Practice Address - Zip Code:43420-1132
Practice Address - Country:US
Practice Address - Phone:419-334-5469
Practice Address - Fax:419-334-5450
Is Sole Proprietor?:No
Enumeration Date:2014-02-25
Last Update Date:2014-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.127323-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse