Individual provider · Type 1 NPI
Kimberley A. Hanneken, MD
Adult Medicine Physician · Ukiah, CA
NPI number
1215047782
Active
Practice location
260 Hospital Dr, Suite 209
Ukiah, CA 95482-4568
Fax (707) 462-7846
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Medicine Physician | 207QA0505X | 036094217 (IL) |
| Adult Medicine Physician Primary | 207QA0505X | G136098 (CA) |
Adult Medicine Physician: The NUCC recommends this code not be used. Choose a more appropriate code.
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About NPI 1215047782
Kimberley A. Hanneken, MD's National Provider Identifier is 1215047782, issued on Aug 30, 2006. The primary taxonomy on file is Adult Medicine Physician (207QA0505X), and the practice location is in Ukiah, CA. The record was last updated on Aug 26, 2015.