Provider Demographics
NPI:1326119314
Name:FELICE, NANCY ANN (CRNP)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:ANN
Last Name:FELICE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:YANDORA
Other - Last Name:FELICE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN, CRNP
Mailing Address - Street 1:506 ATHENA DR
Mailing Address - Street 2:
Mailing Address - City:DELMONT
Mailing Address - State:PA
Mailing Address - Zip Code:15626-1005
Mailing Address - Country:US
Mailing Address - Phone:724-468-6869
Mailing Address - Fax:724-468-6207
Practice Address - Street 1:2480 S GRANDE BLVD
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-8902
Practice Address - Country:US
Practice Address - Phone:724-830-4000
Practice Address - Fax:724-830-4019
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATP000719C363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP34014Medicare UPIN
PA048868Medicare ID - Type Unspecified