MEDICARE: MRS. VICTORIA NANGLE

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1619024114
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. VICTORIA NANGLE

Provider Business Mailing Address
First Line	:	9395 MELROSE ST
Second Line	:
City	:	SPRING HILL
State	:	FL
Zip	:	34608-3428
Country	:	US
Telephone Number	:	727-916-0085
Fax Number	:

Provider Business Practice Location Address
First Line	:	9395 MELROSE ST
Second Line	:
City	:	SPRING HILL
State	:	FL
Zip	:	34608-3428
Country	:	US
Telephone Number	:	727-916-0085
Fax Number	:

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

Provider Enumeration Date	:	01/05/2007
Last Update Date	:	07/09/2007

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