Provider Demographics
NPI:1144201617
Name:VANBEEK, NANCY (RN, NP)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:
Last Name:VANBEEK
Suffix:
Gender:F
Credentials:RN, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 OLD PLANTATION RD
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:VA
Mailing Address - Zip Code:24151-4954
Mailing Address - Country:US
Mailing Address - Phone:540-483-3927
Mailing Address - Fax:
Practice Address - Street 1:390 S MAIN ST
Practice Address - Street 2:SUITE 201
Practice Address - City:ROCKY MOUNT
Practice Address - State:VA
Practice Address - Zip Code:24151-1711
Practice Address - Country:US
Practice Address - Phone:540-484-4800
Practice Address - Fax:540-484-4882
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2008-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001119384163W00000X
VA0024119384363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA8945039Medicaid
500000114Medicare PIN
VA8945039Medicaid
VA017872C18Medicare PIN
500000114Medicare ID - Type Unspecified