Provider Demographics
NPI:1275761397
Name:BREM, NANCY A (LAC)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:A
Last Name:BREM
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10900 N SCOTTSDALE RD STE 106
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-5222
Mailing Address - Country:US
Mailing Address - Phone:480-389-9030
Mailing Address - Fax:
Practice Address - Street 1:10900 N SCOTTSDALE RD STE 106
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-5222
Practice Address - Country:US
Practice Address - Phone:480-389-9030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-26
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0646171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist