Provider Demographics
NPI:1467500546
Name:NANRY, ARLENE (RN)
Entity Type:Individual
Prefix:MRS
First Name:ARLENE
Middle Name:
Last Name:NANRY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 MAJESTIC WAY
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14624-3714
Mailing Address - Country:US
Mailing Address - Phone:585-594-4183
Mailing Address - Fax:
Practice Address - Street 1:6 MAJESTIC WAY
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14624-3714
Practice Address - Country:US
Practice Address - Phone:585-594-4183
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY539022-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02571364Medicaid