Provider Demographics
NPI:1396948295
Name:CHAMPION, NANCY (CRNP)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:
Last Name:CHAMPION
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MRS
Other - First Name:NANCY
Other - Middle Name:
Other - Last Name:RUEHL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:8 S PINE ST
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36604-2518
Mailing Address - Country:US
Mailing Address - Phone:251-675-5034
Mailing Address - Fax:251-675-8511
Practice Address - Street 1:1084 INDUSTRIAL PKWY
Practice Address - Street 2:SUITE C
Practice Address - City:SARALAND
Practice Address - State:AL
Practice Address - Zip Code:36571-3726
Practice Address - Country:US
Practice Address - Phone:251-675-5034
Practice Address - Fax:251-675-8511
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1092613363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner