Provider Demographics
NPI:1942423439
Name:ORTIZ, NANCY ANNE (CFNP CERTIFIED FAMIL)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:ANNE
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:CFNP CERTIFIED FAMIL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 HEARTHSTONE LANE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923
Mailing Address - Country:US
Mailing Address - Phone:865-531-8211
Mailing Address - Fax:865-531-8211
Practice Address - Street 1:1928 ALCOA HWY
Practice Address - Street 2:SUITE 119
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1502
Practice Address - Country:US
Practice Address - Phone:865-305-8779
Practice Address - Fax:865-305-9869
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000116496163W00000X
TNAPN0000007654363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1517035Medicaid
TN103I509039Medicare PIN