Provider Demographics
NPI:1063626927
Name:HANCOCK, LINDA CULLINANE (RN FNP PHD)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:CULLINANE
Last Name:HANCOCK
Suffix:
Gender:F
Credentials:RN FNP PHD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:11336 LUDGATE PLACE
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23831
Mailing Address - Country:US
Mailing Address - Phone:804-314-7167
Mailing Address - Fax:804-828-7949
Practice Address - Street 1:1300 W BROAD ST
Practice Address - Street 2:VCU STUDENT HEALTH SERVICES
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23284-2022
Practice Address - Country:US
Practice Address - Phone:804-828-7815
Practice Address - Fax:804-828-7949
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0024082955363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0024082955OtherFNP