Provider Demographics
NPI:1245510536
Name:HANCOCK, TERRI MICHELLE (DNP, ACNP-BC)
Entity type:Individual
Prefix:MS
First Name:TERRI
Middle Name:MICHELLE
Last Name:HANCOCK
Suffix:
Gender:F
Credentials:DNP, ACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 413035
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84141-3035
Mailing Address - Country:US
Mailing Address - Phone:801-213-3900
Mailing Address - Fax:801-585-3655
Practice Address - Street 1:30 N 1900 E
Practice Address - Street 2:4A100
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84132-0002
Practice Address - Country:US
Practice Address - Phone:801-585-7707
Practice Address - Fax:801-581-7735
Is Sole Proprietor?:No
Enumeration Date:2011-08-18
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT310552-4405363L00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner