Provider Demographics
NPI:1467907410
Name:BINGHAM, NANCY E (FNP-C)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:E
Last Name:BINGHAM
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 746871
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-6871
Mailing Address - Country:US
Mailing Address - Phone:312-733-9730
Mailing Address - Fax:312-929-0373
Practice Address - Street 1:5246 CHAMBERLAYNE RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23227-2950
Practice Address - Country:US
Practice Address - Phone:804-913-7029
Practice Address - Fax:804-368-1477
Is Sole Proprietor?:No
Enumeration Date:2016-08-19
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024173843363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0024173843OtherVIRGINIA MEDICAL LICENSE
VA0017143110OtherVIRGINIA MEDICAL LICENSE TO PRESCRIBE