Provider Demographics
NPI:1043649460
Name:NANCE, SHIRLEY
Entity Type:Individual
Prefix:MRS
First Name:SHIRLEY
Middle Name:
Last Name:NANCE
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:SHIRLEY
Other - Middle Name:MARIE
Other - Last Name:NANCE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:745 W MOANA LN
Mailing Address - Street 2:SUITE 330
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-4991
Mailing Address - Country:US
Mailing Address - Phone:775-788-7600
Mailing Address - Fax:775-788-7611
Practice Address - Street 1:745 W MOANA LN
Practice Address - Street 2:SUITE 330
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-4991
Practice Address - Country:US
Practice Address - Phone:775-788-7600
Practice Address - Fax:775-788-7611
Is Sole Proprietor?:No
Enumeration Date:2013-11-06
Last Update Date:2013-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN33305163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse