Provider Demographics
NPI:1144302183
Name:HANCOCK, LINDA GAIL (CNM)
Entity type:Individual
Prefix:MISS
First Name:LINDA
Middle Name:GAIL
Last Name:HANCOCK
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 WHISPERING WINDS DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072
Mailing Address - Country:US
Mailing Address - Phone:803-808-9556
Mailing Address - Fax:
Practice Address - Street 1:120 N LAKE DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-2836
Practice Address - Country:US
Practice Address - Phone:803-808-1717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCM69459163WW0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCM30OtherPRESCR. AUTHORITY #
SCAPN30OtherSC LIC. #
SCAPN30OtherSC LIC. #