Provider Demographics
NPI:1093215204
Name:HANCOCK, LEANNA DENEE (CPRS)
Entity Type:Individual
Prefix:
First Name:LEANNA
Middle Name:DENEE
Last Name:HANCOCK
Suffix:
Gender:F
Credentials:CPRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 HOLLY ST
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37917-7815
Mailing Address - Country:US
Mailing Address - Phone:865-770-4003
Mailing Address - Fax:865-357-1157
Practice Address - Street 1:417 HOLLY ST
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37917-7815
Practice Address - Country:US
Practice Address - Phone:865-770-4003
Practice Address - Fax:865-357-1157
Is Sole Proprietor?:No
Enumeration Date:2018-02-14
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator