Provider Demographics
NPI:1457534844
Name:HANCOCK, SUSAN HENRY (RN)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:HENRY
Last Name:HANCOCK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1738 CLARK HILLS CIR
Mailing Address - Street 2:
Mailing Address - City:JOHNS ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29455-7605
Mailing Address - Country:US
Mailing Address - Phone:843-559-7931
Mailing Address - Fax:
Practice Address - Street 1:1738 CLARK HILLS CIR
Practice Address - Street 2:
Practice Address - City:JOHNS ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29455-7605
Practice Address - Country:US
Practice Address - Phone:843-559-7931
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-09
Last Update Date:2007-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCR67744163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical