Provider Demographics
NPI:1932194008
Name:STORMER, NANCY K (CNM)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:K
Last Name:STORMER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:886 GALEN DR
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16803-1164
Mailing Address - Country:US
Mailing Address - Phone:814-342-6992
Mailing Address - Fax:814-342-1770
Practice Address - Street 1:220 N FRONT ST # 2
Practice Address - Street 2:
Practice Address - City:PHILIPSBURG
Practice Address - State:PA
Practice Address - Zip Code:16866-1606
Practice Address - Country:US
Practice Address - Phone:814-342-6992
Practice Address - Fax:814-342-1770
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP008750363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA50054248OtherCAPITAL BLUE CROSS
PA1783256OtherHIGHMARK
PA405343OtherHEALTH AMERICA
PA094451Medicare PIN
PA50054248OtherCAPITAL BLUE CROSS