Provider Demographics
NPI:1336430032
Name:MOILANEN, NANCY C (NCLMT)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:C
Last Name:MOILANEN
Suffix:
Gender:F
Credentials:NCLMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1655 N GRANDVIEW LN
Mailing Address - Street 2:SUITE # 2
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-0877
Mailing Address - Country:US
Mailing Address - Phone:701-751-2020
Mailing Address - Fax:701-223-2207
Practice Address - Street 1:1655 N GRANDVIEW LN
Practice Address - Street 2:SUITE # 2
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503-0877
Practice Address - Country:US
Practice Address - Phone:701-751-2020
Practice Address - Fax:701-223-2207
Is Sole Proprietor?:No
Enumeration Date:2011-04-28
Last Update Date:2011-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND933225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist