Provider Demographics
NPI:1851576334
Name:SMITH, NANCY LYNN (RN, CNS)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:LYNN
Last Name:SMITH
Suffix:
Gender:F
Credentials:RN, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1745 E TICONDEROGA DR
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-4218
Mailing Address - Country:US
Mailing Address - Phone:559-977-9457
Mailing Address - Fax:559-433-9641
Practice Address - Street 1:1745 E TICONDEROGA DR
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-4218
Practice Address - Country:US
Practice Address - Phone:559-675-5481
Practice Address - Fax:559-433-9641
Is Sole Proprietor?:No
Enumeration Date:2008-01-03
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACNS2216163WM0102X
CARN236438163WP1700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP1700XNursing Service ProvidersRegistered NursePerinatal
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn