Individual
MRS. TARA M HANCOCK
Active
Individual
MRS. TARA M HANCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
0024166874
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
139698
ANTHEM
VA
05
—
1912930090
—
VA
01
—
484645
NCPPO
VA
01
—
K142-0002
CAREFIRST
DC
Enumeration date
07/09/2006
Last updated
03/20/2015
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