Doctor Name: | ASHLEY HANCOCK |
NPI Number: | 1164801783 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CPNP |
License Number: | 19784 |
Business Practice Address: | 2476 Upper Brush Creek Rd Linden, TN - 370966223 |
Business Phone Number: | 9315895099 |
Business Fax Number: | |
Mailing Address: | 2476 Upper Brush Creek Rd, LINDEN |
State: | TN |
Postal Code: | 370966223 |
Phone Number: | 9315895099 |
Fax Number: | |
NPI Enumeration Date: | 05/28/2015 |
NPI Last Update Date: | 05/28/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0200X |
License Number: | 19784 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |