Provider Demographics
NPI:1821206426
Name:SIGAFOOS, NANCY MARIE (LPN)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:MARIE
Last Name:SIGAFOOS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MS
Other - First Name:NANCY
Other - Middle Name:MARIE
Other - Last Name:SIGAFOOS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:205 WISTERIA DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:OH
Mailing Address - Zip Code:45373-9317
Mailing Address - Country:US
Mailing Address - Phone:937-552-4054
Mailing Address - Fax:937-552-4054
Practice Address - Street 1:205 WISTERIA DR
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:OH
Practice Address - Zip Code:45373-9317
Practice Address - Country:US
Practice Address - Phone:937-552-4054
Practice Address - Fax:937-552-4054
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN095959164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2531380Medicaid