Provider Demographics
NPI:1174179873
Name:HANCOCK, JAMI JO
Entity Type:Individual
Prefix:
First Name:JAMI
Middle Name:JO
Last Name:HANCOCK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:637 CAMINO DEL CONTENTO S
Mailing Address - Street 2:
Mailing Address - City:PUEBLO WEST
Mailing Address - State:CO
Mailing Address - Zip Code:81007-1976
Mailing Address - Country:US
Mailing Address - Phone:719-289-1383
Mailing Address - Fax:
Practice Address - Street 1:637 CAMINO DEL CONTENTO S
Practice Address - Street 2:
Practice Address - City:PUEBLO WEST
Practice Address - State:CO
Practice Address - Zip Code:81007-1976
Practice Address - Country:US
Practice Address - Phone:719-289-1383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-18
Last Update Date:2019-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider