Healthcare Provider Details

I. General information

NPI: 1811170608
Provider Name (Legal Business Name): NANCY KAY HITCHCOCK RN BSN PHN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/14/2007
Last Update Date: 12/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 CAMPUS DRIVE
HANFORD CA
93230
US

IV. Provider business mailing address

330 CAMPUS DR
HANFORD CA
93230-4375
US

V. Phone/Fax

Practice location:
  • Phone: 559-582-3211
  • Fax: 559-584-5672
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number360540
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number360540
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: