Provider Demographics
NPI:1033174990
Name:FLORENCE, NANCY M (CNM)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:M
Last Name:FLORENCE
Suffix:
Gender:F
Credentials:CNM
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 13579
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19612-3579
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:949 NEW HOLLAND RD
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19607-1646
Practice Address - Country:US
Practice Address - Phone:610-777-7222
Practice Address - Fax:610-775-9534
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNM08498367A00000X
PAMW010054176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2621612Medicaid
PA100828447Medicaid
PA100828447Medicaid