Individual
BENJAMIN SCOTT HANENKRATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
2121 LAKE AVE, FORT WAYNE, IN 46805-5100
(260) 426-5431
Mailing address
1831 KENDAWA DR, FORT WAYNE, IN 46815-7937
(260) 445-7179
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
71008283A
IN
Other
Enumeration date
11/09/2018
Last updated
11/21/2023
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