Provider Demographics
NPI:1578600987
Name:ROSS, NANCY D (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:D
Last Name:ROSS
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 W HICKORY ST
Mailing Address - Street 2:
Mailing Address - City:NEVADA
Mailing Address - State:MO
Mailing Address - Zip Code:64772-2059
Mailing Address - Country:US
Mailing Address - Phone:417-448-2011
Mailing Address - Fax:417-448-1917
Practice Address - Street 1:800 W HICKORY ST
Practice Address - Street 2:
Practice Address - City:NEVADA
Practice Address - State:MO
Practice Address - Zip Code:64772-2059
Practice Address - Country:US
Practice Address - Phone:417-448-2011
Practice Address - Fax:417-448-1917
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO02022235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1801944459OtherDISTRICT NPI NUMBER