Provider Demographics
NPI:1407869621
Name:HANCIK, LINDA W (APRN, BC, FNP)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:W
Last Name:HANCIK
Suffix:
Gender:F
Credentials:APRN, BC, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 N KEENE ST
Mailing Address - Street 2:DR. LINDALL PERRY, BOONE CLINIC
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-6625
Mailing Address - Country:US
Mailing Address - Phone:573-874-3300
Mailing Address - Fax:
Practice Address - Street 1:401 N KEENE ST
Practice Address - Street 2:DR. LINDALL PERRY, BOONE CLINIC
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-6625
Practice Address - Country:US
Practice Address - Phone:573-874-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO057960363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO55439Medicare UPIN