Individual
JOHN HANCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
23 PIERSIDE DR APT 227, BALTIMORE, MD 21230-5468
(251) 802-2108
Mailing address
23 PIERSIDE DR APT 227, BALTIMORE, MD 21230-5468
(251) 802-2108
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R209265
MD
367500000X
Certified Registered Nurse Anesthetist
L6-0A11038
DE
367500000X
Certified Registered Nurse Anesthetist
Primary
R209265
MD
367H00000X
Anesthesiologist Assistant
L6-0A11038
DE
Other
Enumeration date
02/06/2014
Last updated
05/19/2025
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