Healthcare Provider Details

I. General information

NPI: 1124942073
Provider Name (Legal Business Name): SCOTT HANCEY PMHNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 S WOODWORTH LOOP
PALMER AK
99645-8984
US

IV. Provider business mailing address

2500 S WOODWORTH LOOP
PALMER AK
99645-8984
US

V. Phone/Fax

Practice location:
  • Phone: 907-861-6000
  • Fax:
Mailing address:
  • Phone: 907-861-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number260231
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: