Provider Demographics
NPI:1700020435
Name:NYSTUEN, NADENE COOK (RN)
Entity Type:Individual
Prefix:MRS
First Name:NADENE
Middle Name:COOK
Last Name:NYSTUEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 E ELLIOT RD
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-6924
Mailing Address - Country:US
Mailing Address - Phone:480-497-0177
Mailing Address - Fax:480-497-4029
Practice Address - Street 1:1101 E ELLIOT RD
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-6924
Practice Address - Country:US
Practice Address - Phone:480-497-0177
Practice Address - Fax:480-497-4029
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-24
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN148786163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse