Provider Demographics
NPI:1073636387
Name:STERN, NANCY (DC)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:
Last Name:STERN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5024 MARTIN PL NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114-4319
Mailing Address - Country:US
Mailing Address - Phone:505-897-0321
Mailing Address - Fax:505-897-0174
Practice Address - Street 1:5024 MARTIN PL NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114-4319
Practice Address - Country:US
Practice Address - Phone:505-897-0321
Practice Address - Fax:505-897-0174
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1271111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor