MEDICARE: MRS. NANCY TANSEY MS, APRN-GNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LG0600X	Gerontology Nurse Practitioner	R89874	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	R89874	OTHER	SC	LICENSE
2	1945	OTHER	SC	SC RN LICENSE

General Provider Information

NPI Number	:	1578518429
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NANCY TANSEY MS, APRN-GNP

Provider Business Mailing Address
First Line	:	8216 DEVON CT
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29572-4178
Country	:	US
Telephone Number	:	843-848-6480
Fax Number	:	843-848-6655

Provider Business Practice Location Address
First Line	:	8216 DEVON CT
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29572-4178
Country	:	US
Telephone Number	:	843-848-6480
Fax Number	:	843-848-6655

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/22/2006
Last Update Date	:	05/20/2011

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