MEDICARE: DENEA HANCOCK

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
1	372500000X	Chore Provider
2	172A00000X	Driver	TC967399	OH

General Provider Information

NPI Number	:	1902627474
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENEA HANCOCK

Provider Business Mailing Address
First Line	:	2321 TAYLOR PARK DR
Second Line	:
City	:	REYNOLDSBURG
State	:	OH
Zip	:	43068-8052
Country	:	US
Telephone Number	:	614-902-8756
Fax Number	:

Provider Business Practice Location Address
First Line	:	2321 TAYLOR PARK DR
Second Line	:
City	:	REYNOLDSBURG
State	:	OH
Zip	:	43068-8052
Country	:	US
Telephone Number	:	614-902-8756
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2024
Last Update Date	:	10/17/2024

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Directions to “ DENEA HANCOCK ” Practice Location

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