Provider Demographics
NPI:1811537517
Name:PANALIGAN, NINA-RIZZA PANCHO (CCRN, CPNP-AC)
Entity Type:Individual
Prefix:
First Name:NINA-RIZZA
Middle Name:PANCHO
Last Name:PANALIGAN
Suffix:
Gender:F
Credentials:CCRN, CPNP-AC
Other - Prefix:
Other - First Name:NINA
Other - Middle Name:PANCHO
Other - Last Name:PANALIGAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CCRN, CPNP-AC
Mailing Address - Street 1:14339 MARINA BAY LN
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77498-7489
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:725 WELCH RD
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-1601
Practice Address - Country:US
Practice Address - Phone:650-724-2926
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-10
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95013618363LP0222X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0222XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics, Critical Care