Provider Demographics
NPI:1720070931
Name:STONE, NANCY ANN TUTTLE (AGNP)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:ANN TUTTLE
Last Name:STONE
Suffix:
Gender:F
Credentials:AGNP
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:ANN
Other - Last Name:TUTTLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:AGNP
Mailing Address - Street 1:1570 NC 8 AND 89 HWY N
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:NC
Mailing Address - Zip Code:27016-7360
Mailing Address - Country:US
Mailing Address - Phone:336-593-2831
Mailing Address - Fax:336-593-5282
Practice Address - Street 1:1570 NC 8 AND 89 HWY N
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:NC
Practice Address - Zip Code:27016-7360
Practice Address - Country:US
Practice Address - Phone:336-593-8281
Practice Address - Fax:336-593-5282
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2018-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC900327363LF0000X, 363L00000X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
2806172Medicare ID - Type Unspecified
P56545Medicare UPIN