Individual
MRS. TARA M HANCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
500 HOSPITAL DR, WARRENTON, VA 20186-3027
(540) 316-5703
(540) 316-5701
Mailing address
68 S SERVICE RD, SUITE 350, MELVILLE, NY 11747-2358
(516) 945-3000
(516) 945-3131
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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