Provider Demographics
NPI:1750869814
Name:MASSEY, NINA YVETTE (FNP-C)
Entity type:Individual
Prefix:
First Name:NINA
Middle Name:YVETTE
Last Name:MASSEY
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5868 BLEVINS CIR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36116-6525
Mailing Address - Country:US
Mailing Address - Phone:334-333-5337
Mailing Address - Fax:
Practice Address - Street 1:1722 PINE ST STE 406
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-1159
Practice Address - Country:US
Practice Address - Phone:334-293-6741
Practice Address - Fax:334-293-6793
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-01
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-128020207Q00000X
GAGAA-NP002333363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty