Healthcare Provider Details

I. General information

NPI: 1245157866
Provider Name (Legal Business Name): TERI HANCOCK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2026
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

584 S COVEY ST
VERNAL UT
84078-3941
US

IV. Provider business mailing address

584 S COVEY ST
VERNAL UT
84078-3941
US

V. Phone/Fax

Practice location:
  • Phone: 435-790-6511
  • Fax:
Mailing address:
  • Phone: 435-790-6511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number2277412-3102
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: