Provider Demographics
NPI:1811015860
Name:FAUST, NANCY D (CFNP)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:D
Last Name:FAUST
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 AGNES RD
Mailing Address - Street 2:PO BOX 138
Mailing Address - City:CORNWALL
Mailing Address - State:NY
Mailing Address - Zip Code:12518
Mailing Address - Country:US
Mailing Address - Phone:845-534-9461
Mailing Address - Fax:
Practice Address - Street 1:SOUTH JUNIOR HIGH SCHOOL
Practice Address - Street 2:33-63 MONUMENT STREET
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550
Practice Address - Country:US
Practice Address - Phone:845-563-7023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF331205363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily