Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LC1500X | Nurse Practitioner - Community Health | 180670 | NC |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 5007410 | NC |
NPI | 1457750267 |
---|---|
Provider Name | Dr. Virginia Hancock |
First Address | Faison, NC 28341-0187 |
Second Address | New Bern, NC 28562 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2014 |
Last Update Date | 22/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1457750267 | (05) | NC |