Provider Demographics
NPI:1891171252
Name:NANCY LEDBETTER RN, CNS, APNG, AOCNS
Entity Type:Organization
Organization Name:NANCY LEDBETTER RN, CNS, APNG, AOCNS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEDBETTER
Authorized Official - Suffix:
Authorized Official - Credentials:RN, CNS, APNG, AOCNS
Authorized Official - Phone:503-245-6516
Mailing Address - Street 1:6274 SW CAPITOL HWY.
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239
Mailing Address - Country:US
Mailing Address - Phone:503-245-6516
Mailing Address - Fax:503-245-5061
Practice Address - Street 1:6274 SW CAPITOL HWY.
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239
Practice Address - Country:US
Practice Address - Phone:503-245-6516
Practice Address - Fax:503-245-5061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-07
Last Update Date:2015-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200270002364SX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SX0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistOncologyGroup - Single Specialty