Provider Demographics
NPI:1598970873
Name:ROE, NANCY (CRNP)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:ROE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 N SHADY RETREAT RD
Mailing Address - Street 2:SUITES 3 AND 4
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-2503
Mailing Address - Country:US
Mailing Address - Phone:215-345-6090
Mailing Address - Fax:215-345-6119
Practice Address - Street 1:708 N SHADY RETREAT RD
Practice Address - Street 2:SUITES 3 AND 4
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-2503
Practice Address - Country:US
Practice Address - Phone:215-345-6090
Practice Address - Fax:215-345-6119
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2014-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAUP004021D363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARN239457LOtherRN LICENSE
PAUP004021DOtherCRNP LICENSE
PA96699OtherNURSING CERTIFICATE
PA000998OtherPRESCRIPTION AUTH