Provider Demographics
NPI:1700062536
Name:HANKINS, JUDITH M (ARNP,CPNP,IBCLC)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:M
Last Name:HANKINS
Suffix:
Gender:F
Credentials:ARNP,CPNP,IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3851 TINKER DIAGONAL ST
Mailing Address - Street 2:
Mailing Address - City:DEL CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73115-2109
Mailing Address - Country:US
Mailing Address - Phone:405-677-1129
Mailing Address - Fax:405-677-8991
Practice Address - Street 1:3851 TINKER DIAGONAL ST
Practice Address - Street 2:
Practice Address - City:DEL CITY
Practice Address - State:OK
Practice Address - Zip Code:73115-2109
Practice Address - Country:US
Practice Address - Phone:405-677-1129
Practice Address - Fax:405-677-8991
Is Sole Proprietor?:No
Enumeration Date:2008-01-10
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0047346363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics