Provider Demographics
NPI:1568890481
Name:WHITCOMB, NANCIE (RN)
Entity Type:Individual
Prefix:
First Name:NANCIE
Middle Name:
Last Name:WHITCOMB
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 1:521 N 6TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98512-6426
Mailing Address - Country:US
Mailing Address - Phone:360-250-3058
Mailing Address - Fax:360-584-9856
Practice Address - Street 1:521 N 6TH AVE SW
Practice Address - Street 2:
Practice Address - City:TUMWATER
Practice Address - State:WA
Practice Address - Zip Code:98512-6426
Practice Address - Country:US
Practice Address - Phone:360-250-3058
Practice Address - Fax:360-584-9856
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-01
Last Update Date:2013-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00081359163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse