Provider Demographics
NPI:1982845236
Name:MCINTOSH, NANCY L (LPN)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:L
Last Name:MCINTOSH
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3477 REDBUD DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:OH
Mailing Address - Zip Code:45373-9345
Mailing Address - Country:US
Mailing Address - Phone:937-510-6782
Mailing Address - Fax:
Practice Address - Street 1:3477 REDBUD DR
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:OH
Practice Address - Zip Code:45373-9345
Practice Address - Country:US
Practice Address - Phone:937-510-6782
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-17
Last Update Date:2009-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 059662164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse