Healthcare Provider Details

I. General information

NPI: 1295614592
Provider Name (Legal Business Name): TRACI HALIA HANCHETT RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2025
Last Update Date: 08/29/2025
Certification Date: 08/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

742 TOWNE CT
ANCHORAGE AK
99504-1629
US

IV. Provider business mailing address

742 TOWNE CT
ANCHORAGE AK
99504-1629
US

V. Phone/Fax

Practice location:
  • Phone: 808-283-8303
  • Fax:
Mailing address:
  • Phone: 808-283-8303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberNURR27759
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: