Provider Demographics
NPI:1780719716
Name:MASON, NANCY JEAN (APRN)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:JEAN
Last Name:MASON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:JEAN
Other - Last Name:FIGGINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN, WHNP
Mailing Address - Street 1:1075 SW GRANDVIEW AVENUE, SUITE 200
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97527
Mailing Address - Country:US
Mailing Address - Phone:541-479-8363
Mailing Address - Fax:541-476-2841
Practice Address - Street 1:1075 SW GRANDVIEW AVE STE 200
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97527-9752
Practice Address - Country:US
Practice Address - Phone:541-479-8363
Practice Address - Fax:913-948-5380
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS45567363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSK40F102Medicare UPIN