Provider Demographics
NPI:1548056997
Name:HANCOCK, GAYLE L
Entity type:Individual
Prefix:
First Name:GAYLE
Middle Name:L
Last Name:HANCOCK
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5114 PENNY LN
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82009-5379
Mailing Address - Country:US
Mailing Address - Phone:307-286-8119
Mailing Address - Fax:
Practice Address - Street 1:5114 PENNY LN
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82009-5379
Practice Address - Country:US
Practice Address - Phone:307-286-8119
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-15
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker