Provider Demographics
NPI:1619926003
Name:HANCOCK, RUTH ANN (MSN, GNP)
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:ANN
Last Name:HANCOCK
Suffix:
Gender:F
Credentials:MSN, GNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 HOSPICE LN
Mailing Address - Street 2:
Mailing Address - City:WINSTON-SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-5766
Mailing Address - Country:US
Mailing Address - Phone:336-768-3972
Mailing Address - Fax:336-659-0461
Practice Address - Street 1:101 HOSPICE LN
Practice Address - Street 2:
Practice Address - City:WINSTON-SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-5766
Practice Address - Country:US
Practice Address - Phone:336-768-3972
Practice Address - Fax:336-659-0461
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC118461363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCS21321Medicare UPIN