Provider Demographics
NPI:1164658837
Name:PRESTON, NANCY J (BSN)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:J
Last Name:PRESTON
Suffix:
Gender:F
Credentials:BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 HWY 83
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:WI
Mailing Address - Zip Code:53027-9777
Mailing Address - Country:US
Mailing Address - Phone:262-673-7723
Mailing Address - Fax:
Practice Address - Street 1:1919 HWY 83
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:WI
Practice Address - Zip Code:53027-9777
Practice Address - Country:US
Practice Address - Phone:262-673-7723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-08
Last Update Date:2009-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI63313-030163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse