Provider Demographics
NPI:1811159825
Name:LANKHORST, ABBY MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:ABBY
Middle Name:MARIE
Last Name:LANKHORST
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 776351
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6351
Mailing Address - Country:US
Mailing Address - Phone:502-559-9411
Mailing Address - Fax:502-272-5339
Practice Address - Street 1:2051 CLEVIDENCE BLVD STE B
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47129-2278
Practice Address - Country:US
Practice Address - Phone:502-629-2030
Practice Address - Fax:502-629-2070
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE6008207V00000X
IL036144613207V00000X
KY57251207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036144613Medicaid
IA1811159825Medicaid
NE10026301600Medicaid
NE47068731799Medicaid