Provider Demographics
NPI:1588895023
Name:HANCOCK, KELLY ANN (ARNP DNP ARNP FNP BC)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:ANN
Last Name:HANCOCK
Suffix:
Gender:F
Credentials:ARNP DNP ARNP FNP BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 30TH ST
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50310-5753
Mailing Address - Country:US
Mailing Address - Phone:515-699-5999
Mailing Address - Fax:515-699-5926
Practice Address - Street 1:2467 SERGEANT ROAD
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51106
Practice Address - Country:US
Practice Address - Phone:712-276-2467
Practice Address - Fax:712-276-2062
Is Sole Proprietor?:No
Enumeration Date:2009-07-31
Last Update Date:2017-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA-100379363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily