Provider Demographics
NPI:1477822625
Name:JENNINGS, NANCY ANN (BSN RN PHN)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:ANN
Last Name:JENNINGS
Suffix:
Gender:F
Credentials:BSN RN PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:695 OLEANDER AVE
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-3924
Mailing Address - Country:US
Mailing Address - Phone:530-891-2740
Mailing Address - Fax:530-891-2873
Practice Address - Street 1:695 OLEANDER AVE
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-3924
Practice Address - Country:US
Practice Address - Phone:530-891-2740
Practice Address - Fax:530-891-2873
Is Sole Proprietor?:No
Enumeration Date:2011-12-16
Last Update Date:2011-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN7106252083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine