Provider Demographics
NPI:1114638038
Name:HANCOCK, SKYLER DANE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:SKYLER
Middle Name:DANE
Last Name:HANCOCK
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:347 E 750 S
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:UT
Mailing Address - Zip Code:84653-5600
Mailing Address - Country:US
Mailing Address - Phone:385-225-0314
Mailing Address - Fax:
Practice Address - Street 1:3534 S 6000 W
Practice Address - Street 2:
Practice Address - City:WEST VALLEY
Practice Address - State:UT
Practice Address - Zip Code:84128-2698
Practice Address - Country:US
Practice Address - Phone:801-969-6264
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-12
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10374865-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily