Provider Demographics
NPI:1528156007
Name:HOCK, CYNTHIA L (NP)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:L
Last Name:HOCK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1028
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:IN
Mailing Address - Zip Code:47547-1028
Mailing Address - Country:US
Mailing Address - Phone:812-481-1088
Mailing Address - Fax:812-481-8497
Practice Address - Street 1:105 COOPER ST
Practice Address - Street 2:
Practice Address - City:LOOGOOTEE
Practice Address - State:IN
Practice Address - Zip Code:47553-2223
Practice Address - Country:US
Practice Address - Phone:812-295-2812
Practice Address - Fax:812-295-3726
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71001187A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000598611OtherANTHEM
IN200359600Medicaid
IN258190EEMedicare PIN
INP44611Medicare UPIN