Provider Demographics
NPI:1619024114
Name:NANGLE, VICTORIA
Entity Type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:
Last Name:NANGLE
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 1:9395 MELROSE ST
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34608-3428
Mailing Address - Country:US
Mailing Address - Phone:727-916-0085
Mailing Address - Fax:
Practice Address - Street 1:9395 MELROSE ST
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34608-3428
Practice Address - Country:US
Practice Address - Phone:727-916-0085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator