Individual
KATHRYN HANCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4199 GATEWAY BLVD, NEWBURGH, IN 47630-8940
(812) 842-4200
(812) 602-3174
Mailing address
4199 GATEWAY BLVD, NEWBURGH, IN 47630-8940
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28229473A
IN
363L00000X
Nurse Practitioner
Primary
71008820A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
71008820A
IN APN LICENSE
IN
01
—
71008820B
IN CSR LICENSURE
IN
Enumeration date
02/07/2019
Last updated
02/05/2021
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