person
Kimberley A Hanneken, MD
Adult Medicine Physician in Ukiah, California
NPI 1215047782

Kimberley A Hanneken is an Adult Medicine Physician based in Ukiah, CA and is specialized in Adult Medicine. Kimberley A Hanneken practices in Ukiah, CA and has the professional credentials of MD. The NPI Number for Kimberley A Hanneken is 1215047782 and holds a License No. 036094217 (California).

The current practice location address for Kimberley A Hanneken is 260 Hospital Dr, Ukiah, CA and can be reached out via phone at 707-463-7488 and via fax at 707-462-7846.

Location: 260 Hospital Dr, Ukiah, CA, 95482-4568
person
Provider Profile Details
NPI Number
1215047782
Provider Name
Kimberley A Hanneken
Credential
MD
Provider Entity Type
Individual
Gender
Female
Address
260 Hospital Dr, Ukiah, CA, 95482-4568
Phone Number
707-463-7488
Fax Number
707-462-7846
Provider Enumeration Date
08/30/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1043486731 01 IL HEALTH ALLIANCE
036094217 05 IL
216239 01 IL MEDICARE GROUP PTAN
1326041229 01 IL MEDICARE GROUP NPI
institution
Provider Business Practice Location Address Details
Address
260 Hospital Dr
City
State
Zip
95482-4568
Phone Number
707-463-7488
Fax Number
707-462-7846
person
Provider Business Mailing Address Details
Address
260 Hospital Dr
City
State
Zip
95482-4568
Phone Number
707-463-7488
Fax Number
707-462-7846
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Family Medicine
Speciality
Adult Medicine
Taxonomy
License No.
036094217 (Illinois)
Definition
Definition to come.
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