Provider Demographics
NPI:1649691635
Name:GORBY, NANCY ANNE (STNA)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:ANNE
Last Name:GORBY
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1330 HANOVER RD
Mailing Address - Street 2:LOT 110
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-9844
Mailing Address - Country:US
Mailing Address - Phone:740-363-9544
Mailing Address - Fax:
Practice Address - Street 1:1330 HANOVER RD
Practice Address - Street 2:LOT 110
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-9844
Practice Address - Country:US
Practice Address - Phone:740-363-9544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-18
Last Update Date:2013-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCHW001873747P1801X
OH401414250712376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCHW.00187OtherSTATE OF OHIO BOARD OF NURSING