Provider Demographics
NPI:1679808455
Name:BYRNE, NANCY M (LAC)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:M
Last Name:BYRNE
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 MILL PLAIN RD STE 3
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-5036
Mailing Address - Country:US
Mailing Address - Phone:917-783-7825
Mailing Address - Fax:
Practice Address - Street 1:85 MILL PLAIN RD STE 3
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-5036
Practice Address - Country:US
Practice Address - Phone:917-783-7825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-12
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT00693171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist