Healthcare Provider Details

I. General information

NPI: 1447673363
Provider Name (Legal Business Name): REGINA MARIE HANCOCK APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2014
Last Update Date: 11/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16901 LAKESIDE HILLS COURT ATTN: HOSPITAL MEDICINE
OMAHA NE
68130-2318
US

IV. Provider business mailing address

16901 LAKESIDE HILLS COURT ATTN: HOSPITAL MEDICINE
OMAHA NE
68130
US

V. Phone/Fax

Practice location:
  • Phone: 402-717-8434
  • Fax: 402-717-7340
Mailing address:
  • Phone: 855-524-4001
  • Fax: 402-717-7340

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number111622
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: