Provider Demographics
NPI:1457659104
Name:HANCOCK, JANDRA G (ARNP)
Entity Type:Individual
Prefix:
First Name:JANDRA
Middle Name:G
Last Name:HANCOCK
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8804 RENNER BLVD
Mailing Address - Street 2:STE 200
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66219
Mailing Address - Country:US
Mailing Address - Phone:913-676-8400
Mailing Address - Fax:913-599-1692
Practice Address - Street 1:8804 RENNER BLVD
Practice Address - Street 2:STE 200
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66219
Practice Address - Country:US
Practice Address - Phone:913-676-8400
Practice Address - Fax:913-599-1692
Is Sole Proprietor?:No
Enumeration Date:2011-03-04
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-75337-061364SF0001X
KS53-75337363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health