Provider Demographics
NPI:1841362415
Name:NAGY-CORDRAY, JENNIFER LEE (MEDICAL MASSAGE)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LEE
Last Name:NAGY-CORDRAY
Suffix:
Gender:F
Credentials:MEDICAL MASSAGE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1528 PLUMAS CT
Mailing Address - Street 2:SUITE 300
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991-2972
Mailing Address - Country:US
Mailing Address - Phone:530-751-5166
Mailing Address - Fax:530-751-1575
Practice Address - Street 1:1528 PLUMAS CT
Practice Address - Street 2:SUITE 300
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-2972
Practice Address - Country:US
Practice Address - Phone:530-751-5166
Practice Address - Fax:530-751-1575
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2012-07-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA63473174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist