Provider Demographics
NPI:1265637805
Name:RAAB, NANCY SUNDIN (ARNP)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:SUNDIN
Last Name:RAAB
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MRS
Other - First Name:NANCY
Other - Middle Name:SUNDIN
Other - Last Name:RAAB-POYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:7036 ASHTON ST
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-6045
Mailing Address - Country:US
Mailing Address - Phone:561-733-5705
Mailing Address - Fax:561-733-5037
Practice Address - Street 1:10151 ENTERPRISE CENTER BLVD
Practice Address - Street 2:SUITE 205
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-3759
Practice Address - Country:US
Practice Address - Phone:561-732-8102
Practice Address - Fax:561-732-8401
Is Sole Proprietor?:No
Enumeration Date:2007-06-15
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9171035363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAE366Medicare PIN
FL31485VMedicare PIN