Provider Demographics
NPI:1013029412
Name:NOVIG, NANCY (CRNA, MS)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:
Last Name:NOVIG
Suffix:
Gender:F
Credentials:CRNA, MS
Other - Prefix:MS
Other - First Name:NANCY
Other - Middle Name:
Other - Last Name:NOVIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA, MS
Mailing Address - Street 1:500 NE MULTNOMAH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97232-2023
Mailing Address - Country:US
Mailing Address - Phone:503-813-3860
Mailing Address - Fax:
Practice Address - Street 1:10180 SE SUNNYSIDE RD
Practice Address - Street 2:
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-8970
Practice Address - Country:US
Practice Address - Phone:503-813-3860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2018-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200950055NP363LP0808X
OR200260038CRNA367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health