Organization
SIMPLECLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN DANIEL HANCOCK NP (OWNER/PROVIDER)
(910) 491-4530
Entity
Organization
Contact information
Practice address
1515 SUNSET AVE, CLINTON, NC 28328-3827
(910) 491-9418
(866) 488-6433
Mailing address
PO BOX 727, STEDMAN, NC 28391-0727
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
NC
Enumeration date
05/29/2019
Last updated
05/31/2019
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