Provider Demographics
NPI:1609685155
Name:HANKE, STEPHANIE DIANE
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:DIANE
Last Name:HANKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:DIANE
Other - Last Name:TENBENSEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:502 W DERBY ST
Mailing Address - Street 2:PO BOX 637
Mailing Address - City:OXFORD
Mailing Address - State:NE
Mailing Address - Zip Code:68967-0637
Mailing Address - Country:US
Mailing Address - Phone:308-824-3283
Mailing Address - Fax:308-824-3356
Practice Address - Street 1:502 W DERBY ST
Practice Address - Street 2:PO BOX 637
Practice Address - City:OXFORD
Practice Address - State:NE
Practice Address - Zip Code:68967-0637
Practice Address - Country:US
Practice Address - Phone:308-824-3283
Practice Address - Fax:308-824-3356
Is Sole Proprietor?:No
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion