Provider Demographics
NPI:1760582548
Name:FIELDS, NANCY J (RN)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:J
Last Name:FIELDS
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 1:630 NORTHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:IN
Mailing Address - Zip Code:47374-1530
Mailing Address - Country:US
Mailing Address - Phone:765-939-2871
Mailing Address - Fax:
Practice Address - Street 1:RICHMOND VA CLINIC
Practice Address - Street 2:4351 SOUTH A STREET
Practice Address - City:RICHMOND
Practice Address - State:IN
Practice Address - Zip Code:47374-1530
Practice Address - Country:US
Practice Address - Phone:765-973-6915
Practice Address - Fax:765-965-6936
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28109884A163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse