Doctor Name: | MR. TERRY WAYNE HANCOCK |
NPI Number: | 1295734945 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MSN, RN,BC FNP |
License Number: | 42137 |
Business Practice Address: | 200 Neel Ave Socorro, NM - 878014649 |
Business Phone Number: | 5754189563 |
Business Fax Number: | |
Mailing Address: | 200 Neel Ave, SOCORRO |
State: | NM |
Postal Code: | 878014649 |
Phone Number: | 5754189563 |
Fax Number: | |
NPI Enumeration Date: | 07/15/2005 |
NPI Last Update Date: | 08/09/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 42137 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |