Provider Demographics
NPI:1487989257
Name:HANCOCK, ALAN RAY (RN, APRN)
Entity type:Individual
Prefix:MR
First Name:ALAN
Middle Name:RAY
Last Name:HANCOCK
Suffix:
Gender:M
Credentials:RN, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3057 HIGHWAY 80 W
Mailing Address - Street 2:
Mailing Address - City:CALHOUN
Mailing Address - State:LA
Mailing Address - Zip Code:71225-7907
Mailing Address - Country:US
Mailing Address - Phone:318-644-5838
Mailing Address - Fax:318-644-5836
Practice Address - Street 1:3057 HIGHWAY 80 W
Practice Address - Street 2:
Practice Address - City:CALHOUN
Practice Address - State:LA
Practice Address - Zip Code:71225-7907
Practice Address - Country:US
Practice Address - Phone:318-644-5838
Practice Address - Fax:318-644-5836
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-12
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN099208-AP05958363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily