Provider Demographics
NPI:1396030045
Name:HANCOCK, DAWN MICHELLE (NP)
Entity Type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:MICHELLE
Last Name:HANCOCK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1949 GUNBARREL ROAD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421
Mailing Address - Country:US
Mailing Address - Phone:706-876-2130
Mailing Address - Fax:706-876-2168
Practice Address - Street 1:7550 GOODWIN ROAD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421
Practice Address - Country:US
Practice Address - Phone:706-876-2130
Practice Address - Fax:706-876-2168
Is Sole Proprietor?:No
Enumeration Date:2011-06-10
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN15174363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics