Provider Demographics
NPI:1962480236
Name:HANCOCK, GLORIA SELLERS (FNP-C)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:SELLERS
Last Name:HANCOCK
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 WILLARD DR
Mailing Address - Street 2:
Mailing Address - City:CODY
Mailing Address - State:WY
Mailing Address - Zip Code:82414-7812
Mailing Address - Country:US
Mailing Address - Phone:307-578-9095
Mailing Address - Fax:307-578-9095
Practice Address - Street 1:26 WILLARD DR
Practice Address - Street 2:
Practice Address - City:CODY
Practice Address - State:WY
Practice Address - Zip Code:82414-7812
Practice Address - Country:US
Practice Address - Phone:307-578-9095
Practice Address - Fax:307-578-9095
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-05
Last Update Date:2019-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY306461176363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily