Provider Demographics
NPI:1114017563
Name:BERNSTETTER, NANCY ELLEN (RN)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:ELLEN
Last Name:BERNSTETTER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:628 N DAHLIA PL
Mailing Address - Street 2:
Mailing Address - City:CANBY
Mailing Address - State:OR
Mailing Address - Zip Code:97013-3335
Mailing Address - Country:US
Mailing Address - Phone:503-266-3035
Mailing Address - Fax:
Practice Address - Street 1:628 N DAHLIA PL
Practice Address - Street 2:
Practice Address - City:CANBY
Practice Address - State:OR
Practice Address - Zip Code:97013-3335
Practice Address - Country:US
Practice Address - Phone:503-266-3035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health