Provider Demographics
NPI:1558072744
Name:NAHORODNY, NANCY
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:NAHORODNY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 FIELD AVE
Mailing Address - Street 2:
Mailing Address - City:COTTRELLVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48039-2810
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1309 S LINDEN RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3443
Practice Address - Country:US
Practice Address - Phone:810-732-8087
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-08
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4703119592164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse