| Mrs Nicole L Hancock, RD | |
|
35629 Highway 72, Salem, MO 65560-7217 | |
| (573) 729-5917 | |
| (573) 729-5636 |
| Full Name | Mrs Nicole L Hancock |
|---|---|
| Gender | Female |
| Speciality | Dietitian, Registered |
| Location | 35629 Highway 72, Salem, Missouri |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548682339 | NPI | - | NPPES |
| 350081231 | Medicaid | MO | |
| 0957151 | Other | MO | CIGNA PID |
| 26D0446923 | Other | MO | CLIA (TCMH) |
| 003775591 | Other | MO | UHC MPIN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133V00000X | Dietitian, Registered | 2460 (Tennessee) | Secondary |
| 133V00000X | Dietitian, Registered | 2010033235 (Missouri) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Nicole L Hancock, RD 1084 County Road 2630, Salem, MO 65560-7967 Ph: (417) 547-3373 | Mrs Nicole L Hancock, RD 35629 Highway 72, Salem, MO 65560-7217 Ph: (573) 729-5917 |
Jason Edwards, LICENSED DIETITIAN Dietitian Medicare: Not Enrolled in Medicare Practice Location: Hwy 72 North, Salem, MO 65560 Phone: 573-729-6626 Fax: 573-729-6502 |