Provider Demographics
NPI:1700045325
Name:HANKS, DAWN MARIE (RN)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:MARIE
Last Name:HANKS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 H ST
Mailing Address - Street 2:
Mailing Address - City:POPLAR
Mailing Address - State:MT
Mailing Address - Zip Code:59255
Mailing Address - Country:US
Mailing Address - Phone:406-768-3491
Mailing Address - Fax:406-768-3014
Practice Address - Street 1:107 H ST
Practice Address - Street 2:
Practice Address - City:POPLAR
Practice Address - State:MT
Practice Address - Zip Code:59255
Practice Address - Country:US
Practice Address - Phone:406-768-3491
Practice Address - Fax:406-768-3014
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR26027163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NDR26027OtherND BOARD OF NURSING
MT2210068Medicaid