Doctor Name: | MRS. HEATHER HANCOCK |
NPI Number: | 1518168210 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | R860271 |
Business Practice Address: | 1031 Northridge Rd Baldwyn, MS - 388241173 |
Business Phone Number: | 6623659305 |
Business Fax Number: | 6623659304 |
Mailing Address: | 1031 Northridge Rd, BALDWYN |
State: | MS |
Postal Code: | 388241173 |
Phone Number: | 6623659305 |
Fax Number: | 6623659304 |
NPI Enumeration Date: | 05/30/2007 |
NPI Last Update Date: | 12/20/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | R860271 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MS |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |