Provider Demographics
NPI:1457617128
Name:PARTRIDGE, NILA REBECCA (RN)
Entity Type:Individual
Prefix:
First Name:NILA
Middle Name:REBECCA
Last Name:PARTRIDGE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 CANDLEWYCK DR APT 705
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49001-5486
Mailing Address - Country:US
Mailing Address - Phone:269-365-0655
Mailing Address - Fax:
Practice Address - Street 1:320 BRIGHAM ST
Practice Address - Street 2:
Practice Address - City:PLAINWELL
Practice Address - State:MI
Practice Address - Zip Code:49080-1577
Practice Address - Country:US
Practice Address - Phone:269-685-9805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-07
Last Update Date:2012-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704260483163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse