Hanneken, Kimberley A
Hanneken, Kimberley A is an individual health care provider with primary practice located at 260 Hospital Dr Suite 209, Ukiah CA 95482-4568. She recently has only one registered license in Allopathic & Osteopathic Physicians / Adult Medicine, which is considered as her primary health care specialty. Hanneken, Kimberley A can be contacted via phone (707) 463-7488.Contact Information
Primary practice address
260 Hospital Dr Suite 209
Ukiah CA 95482-4568
Phone: (707) 463-7488
Fax: (707) 462-7846
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Adult Medicine | 207QA0505X | 036094217 | Illinois |
| Allopathic & Osteopathic Physicians / Adult Medicine | 207QA0505X | G136098 | California |
Profile Details
| NPI number | 1215047782 |
|---|---|
| LBN Legal business name | Hanneken, Kimberley A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 30th, 2006 |
| Last updated | Aug 26th, 2015 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215047782 | NPPES |
| Illinois | Other | 1043486731 | HEALTH ALLIANCE |
| Illinois | MEDICAID | 036094217 | HEALTH ALLIANCE |
| Illinois | Other | 216239 | HEALTH ALLIANCE |
| Illinois | Other | 1326041229 | HEALTH ALLIANCE |
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