Individual
MARY JANE HANCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
2451 FILLINGIM ST, MASTIN 102, MOBILE, AL 36617-2238
(251) 470-5890
(251) 471-7925
Mailing address
PO BOX 40480, MOBILE, AL 36640-0480
(251) 470-5890
(251) 471-7925
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
1-079750
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02332297
—
MS
05
—
308131100
—
FL
01
—
51538577
BCBS - STANTON RD
AL
01
—
51540552
BCBS - MED PK DR
AL
05
—
891013340
—
AL
05
—
891013570
—
AL
Enumeration date
11/13/2006
Last updated
05/16/2014
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