Provider Demographics
NPI:1447673363
Name:HANCOCK, REGINA MARIE (APRN, FNP-BC)
Entity type:Individual
Prefix:
First Name:REGINA
Middle Name:MARIE
Last Name:HANCOCK
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:16901 LAKESIDE HILLS COURT
Mailing Address - Street 2:ATTN: HOSPITAL MEDICINE
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68130
Mailing Address - Country:US
Mailing Address - Phone:855-524-4001
Mailing Address - Fax:402-717-7340
Practice Address - Street 1:16901 LAKESIDE HILLS COURT
Practice Address - Street 2:ATTN: HOSPITAL MEDICINE
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68130-2318
Practice Address - Country:US
Practice Address - Phone:402-717-8434
Practice Address - Fax:402-717-7340
Is Sole Proprietor?:No
Enumeration Date:2014-01-29
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE111622363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025519100Medicaid
NE098684524OtherMEDICARE PTAN