Provider Demographics
NPI:1164016093
Name:HANCOCK, CIERRA (LPN)
Entity Type:Individual
Prefix:
First Name:CIERRA
Middle Name:
Last Name:HANCOCK
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4941 E 86TH ST
Mailing Address - Street 2:
Mailing Address - City:GARFIELD HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44125-2022
Mailing Address - Country:US
Mailing Address - Phone:216-313-1902
Mailing Address - Fax:
Practice Address - Street 1:15113 RUBY LN
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44128-4195
Practice Address - Country:US
Practice Address - Phone:216-313-1902
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-22
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH147877164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse