Individual
AMANDA HANCKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
13601 PRESTON RD, STE 1000W, DALLAS, TX 75240-4911
(972) 663-8523
(972) 663-8329
Mailing address
PO BOX 650426, DALLAS, TX 75265-0426
(972) 663-8523
(972) 663-8329
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
072225
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
746485
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
188315902
—
TX
05
—
8052245
—
NC
01
—
89588U
BCBS
TX
01
—
P00719271
RAILROAD
TX
Enumeration date
09/28/2006
Last updated
04/13/2012
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