Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 04-38991 | KS |
N | 208000000X | Pediatrician | 2016014396 | MO |
N | 208000000X | Pediatrician | 4301099903 | MI |
N | 2080P0202X | Pediatric Cardiologist | 04-38991 | KS |
Y | 2080P0202X | Pediatric Cardiologist | 2016014396 | MO |
N | 2080P0202X | Pediatric Cardiologist | 4301099903 | MI |
NPI | 1265675938 |
---|---|
Provider Name | Hayley Suzanne Graue Hancock |
First Address | Kansas City, MO 64108-4619 |
Second Address | Kansas City, MO 64108-4619 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2009 |
Last Update Date | 02/08/2016 |