Provider Demographics
NPI:1912902339
Name:AGNEW, NANCY J (ARNP)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:J
Last Name:AGNEW
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:J
Other - Last Name:SWIFT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:865 LINCOLN RD
Mailing Address - Street 2:STE L10
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-4159
Mailing Address - Country:US
Mailing Address - Phone:563-355-9191
Mailing Address - Fax:563-355-3419
Practice Address - Street 1:1230 E RUSHOLME ST
Practice Address - Street 2:STE 301
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52803-2400
Practice Address - Country:US
Practice Address - Phone:563-322-9150
Practice Address - Fax:563-322-9148
Is Sole Proprietor?:No
Enumeration Date:2005-06-14
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAF047883363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0419648Medicaid
065363OtherHEALTH ALLIANCE
4796890013OtherDMERC
156398OtherIOWA HEALTH SOLUTIONS
IA0101OtherJOHN DEERE HEALTH PLAN
IA0419648Medicaid
065363OtherHEALTH ALLIANCE