Provider Demographics
NPI:1730485525
Name:DEKLYN, NANCY LATHAM (RN)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:LATHAM
Last Name:DEKLYN
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 1:564 RIO LINDO AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-1852
Mailing Address - Country:US
Mailing Address - Phone:530-879-3950
Mailing Address - Fax:
Practice Address - Street 1:564 RIO LINDO AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-1852
Practice Address - Country:US
Practice Address - Phone:530-879-3950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-27
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA738504163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse