Provider Demographics
NPI:1669369716
Name:PHELAN, NINA (CLEC, HBCE, CHT)
Entity type:Individual
Prefix:MRS
First Name:NINA
Middle Name:
Last Name:PHELAN
Suffix:
Gender:F
Credentials:CLEC, HBCE, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 PASADENA AVE APT 6
Mailing Address - Street 2:
Mailing Address - City:SOUTH PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91030-2937
Mailing Address - Country:US
Mailing Address - Phone:323-810-1519
Mailing Address - Fax:
Practice Address - Street 1:320 PASADENA AVE APT 6
Practice Address - Street 2:
Practice Address - City:SOUTH PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91030-2937
Practice Address - Country:US
Practice Address - Phone:323-810-1519
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-20
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula