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Individual

EDWIN HANCOCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
APRN

Contact information

Practice address
2609 NEW HARTFORD RD STE 3, OWENSBORO, KY 42303-1316
(812) 476-7111
(812) 476-7117
Mailing address
PO BOX 21890, BELFAST, ME 04915-4115
(502) 907-0356
(502) 919-9780

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3016618
KY
363LP2300X
Primary Care Nurse Practitioner
3016618
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
300061509
IN
05
7100767930
KY
Enumeration date
09/02/2021
Last updated
06/09/2022
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