Provider Demographics
NPI:1386847960
Name:KHOURY, NANCY CAROL (RN)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:CAROL
Last Name:KHOURY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:
Other - Last Name:KHOURY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:305 NORWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:TOCCOA
Mailing Address - State:GA
Mailing Address - Zip Code:30577-3178
Mailing Address - Country:US
Mailing Address - Phone:706-886-5307
Mailing Address - Fax:
Practice Address - Street 1:305 NORWOOD AVE
Practice Address - Street 2:
Practice Address - City:TOCCOA
Practice Address - State:GA
Practice Address - Zip Code:30577-3178
Practice Address - Country:US
Practice Address - Phone:706-886-5307
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN171381163WX0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0002XNursing Service ProvidersRegistered NurseObstetric, High-Risk