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Individual
MRS. LORI GAIL HANKENSON
Active
Individual
MRS. LORI GAIL HANKENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD16290
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
021993006
BLUE CROSS
OR
05
—
067053
—
OR
01
—
93112982997006A007
TRI WEST
—
01
—
B85008
PROVIDENCE HEALTH PLAN
OR
Enumeration date
05/01/2006
Last updated
02/24/2012
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