Provider Demographics
NPI:1952497828
Name:PAGE, NANCY J (RN)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:J
Last Name:PAGE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8735 N OAK FOREST DR
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86305-8701
Mailing Address - Country:US
Mailing Address - Phone:928-717-3266
Mailing Address - Fax:928-717-3262
Practice Address - Street 1:146 S GRANITE ST
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86303-4710
Practice Address - Country:US
Practice Address - Phone:928-717-3266
Practice Address - Fax:928-717-3262
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN067814163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool