Provider Demographics
NPI:1205940244
Name:BEHRENS, NANCY VIRGINIA (MD)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:VIRGINIA
Last Name:BEHRENS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:704-316-5000
Mailing Address - Fax:704-316-5010
Practice Address - Street 1:14135 BALLANTYNE CORPORATE PL STE 160
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-4221
Practice Address - Country:US
Practice Address - Phone:704-316-5000
Practice Address - Fax:704-316-5010
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2006-018472084S0012X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5905452Medicaid
NC5905452Medicaid
NC2060301AMedicare PIN