Provider Demographics
NPI:1346287901
Name:ARMETTA, NANCY A (MD)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:A
Last Name:ARMETTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 REDBUD LN
Mailing Address - Street 2:P.O. BOX 937
Mailing Address - City:WAYNESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:38485-5047
Mailing Address - Country:US
Mailing Address - Phone:931-722-5677
Mailing Address - Fax:931-722-2236
Practice Address - Street 1:126 REDBUD LN
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:TN
Practice Address - Zip Code:38485-5047
Practice Address - Country:US
Practice Address - Phone:931-722-5677
Practice Address - Fax:931-722-2236
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-01
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD016688207Q00000X
NC2013-01400207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3827941Medicaid
TNP00160734OtherRAILROAD MEDICARE
TN4156496OtherBCBS
TN3827941Medicaid
TN3827941Medicaid
TN3827941Medicaid