Provider Demographics
NPI:1942353370
Name:HONEYCHUCK, NANCY A (FNP)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:A
Last Name:HONEYCHUCK
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:632 E SANGERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:SANGERVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04479-3227
Mailing Address - Country:US
Mailing Address - Phone:716-361-9167
Mailing Address - Fax:
Practice Address - Street 1:632 E SANGERVILLE RD
Practice Address - Street 2:
Practice Address - City:SANGERVILLE
Practice Address - State:ME
Practice Address - Zip Code:04479-3227
Practice Address - Country:US
Practice Address - Phone:716-361-9167
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2602363L00000X
MNR207225-6363L00000X
AZAP2456363LF0000X
ME191177363LP2300X
MECNP191177363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
SDENROLLEDMedicaid
MNENROLLEDMedicaid
AZ142862Medicaid
AZ142862Medicaid