Provider Demographics
NPI:1780387415
Name:DIANE HANKS PLLC
Entity type:Organization
Organization Name:DIANE HANKS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FNP-C FPMHNP-BC
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:LORRAINE
Authorized Official - Last Name:HANKS
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C FPMHNP-BC
Authorized Official - Phone:509-410-5130
Mailing Address - Street 1:705 GAGE BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-9716
Mailing Address - Country:US
Mailing Address - Phone:509-410-5130
Mailing Address - Fax:509-987-1011
Practice Address - Street 1:705 GAGE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-9716
Practice Address - Country:US
Practice Address - Phone:509-410-5130
Practice Address - Fax:509-987-1011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-22
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty