Provider Demographics
NPI:1962847038
Name:HANCOCK, JENNIFER N
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:N
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 1:7403 N BOSTON PL
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85741-2111
Mailing Address - Country:US
Mailing Address - Phone:520-245-3459
Mailing Address - Fax:520-395-0192
Practice Address - Street 1:7403 N BOSTON PL
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741-2111
Practice Address - Country:US
Practice Address - Phone:520-245-3459
Practice Address - Fax:520-395-0192
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-02
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider