Provider Demographics
NPI:1972174746
Name:PAULIDES, NANCY (BSN, MED,RN)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:PAULIDES
Suffix:
Gender:F
Credentials:BSN, MED,RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 PEASE RD
Mailing Address - Street 2:
Mailing Address - City:EAST LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01028-3111
Mailing Address - Country:US
Mailing Address - Phone:413-265-1177
Mailing Address - Fax:
Practice Address - Street 1:54 PEASE RD
Practice Address - Street 2:
Practice Address - City:EAST LONGMEADOW
Practice Address - State:MA
Practice Address - Zip Code:01028-3111
Practice Address - Country:US
Practice Address - Phone:413-265-1177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-02
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN206421163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse