Provider Demographics
NPI:1780601542
Name:HANKS, DEBORAH (FNP)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:HANKS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63701 E SADDLEBROOKE BLVD STE F
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85739-1273
Mailing Address - Country:US
Mailing Address - Phone:520-818-0300
Mailing Address - Fax:520-818-2508
Practice Address - Street 1:63701 E SADDLEBROOKE BLVD STE F
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85739-1273
Practice Address - Country:US
Practice Address - Phone:520-818-0300
Practice Address - Fax:520-818-2508
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP1421363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ645773Medicaid
AZ645773Medicaid