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NPI Code Detail

MEDICARE: DR. AUDREY NAGLE MD

MEDICARE: DR. AUDREY NAGLE MD
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
12080N0001XNeonatal-Perinatal Medicine PhysicianA77548CA

General Provider Information

NPI Number : 1609858802
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AUDREY NAGLE MD
Provider Business Mailing Address
First Line : 1141 PEAR TREE LN
Second Line : SUITE 100
City : NAPA
State : CA
Zip : 94558-6484
Country : US
Telephone Number : 707-254-1770
Fax Number :
Provider Business Practice Location Address
First Line : 1425 S MAIN ST
Second Line :
City : WALNUT CREEK
State : CA
Zip : 94596-5318
Country : US
Telephone Number : 707-718-0651
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2005
Last Update Date : 12/13/2021

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Directions to “ DR. AUDREY NAGLE MD” Practice Location

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