Provider Demographics
NPI:1639403926
Name:MANTZ, NANCY K (CRNP)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:K
Last Name:MANTZ
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:PO BOX 1549
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16003-1549
Mailing Address - Country:US
Mailing Address - Phone:724-284-5670
Mailing Address - Fax:724-284-4144
Practice Address - Street 1:1 HOSPITAL WAY
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-4670
Practice Address - Country:US
Practice Address - Phone:724-431-0550
Practice Address - Fax:724-477-7208
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-21
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAUP006480W363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner