Provider Demographics
NPI:1639218530
Name:HOUY, NANCY MARIE (NPP/ FNP)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:MARIE
Last Name:HOUY
Suffix:
Gender:F
Credentials:NPP/ FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 ALGER RD
Mailing Address - Street 2:
Mailing Address - City:ARKPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14807-9347
Mailing Address - Country:US
Mailing Address - Phone:607-382-1870
Mailing Address - Fax:
Practice Address - Street 1:115 LIBERTY ST
Practice Address - Street 2:
Practice Address - City:BATH
Practice Address - State:NY
Practice Address - Zip Code:14810-1508
Practice Address - Country:US
Practice Address - Phone:607-664-2255
Practice Address - Fax:607-664-2162
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF332021363LF0000X
NYF400887-1363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01804264Medicaid
NYCC2634Medicare ID - Type Unspecified