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NPI Code Detail

MEDICARE: MRS. LINDA CULLINANE HANCOCK RN FNP PHD

MEDICARE:  MRS. LINDA CULLINANE HANCOCK  RN FNP PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner0024082955VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10024082955OTHERVAFNP

General Provider Information

NPI Number : 1063626927
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LINDA CULLINANE HANCOCK RN FNP PHD
Provider Business Mailing Address
First Line : 11336 LUDGATE PLACE
Second Line :
City : CHESTER
State : VA
Zip : 23831
Country : US
Telephone Number : 804-314-7167
Fax Number : 804-828-7949
Provider Business Practice Location Address
First Line : 1300 W BROAD ST
Second Line : VCU STUDENT HEALTH SERVICES
City : RICHMOND
State : VA
Zip : 23284-2022
Country : US
Telephone Number : 804-828-7815
Fax Number : 804-828-7949
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2007
Last Update Date : 07/08/2007

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