MEDICARE: NANCY PACE

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	363LF0000X	Family Nurse Practitioner	APRN.CNP.023929	OH

General Provider Information

NPI Number	:	1750853743
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY PACE

Provider Business Mailing Address
First Line	:	4685 FOREST AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45212-3397
Country	:	US
Telephone Number	:	513-853-4702
Fax Number	:	513-852-8525

Provider Business Practice Location Address
First Line	:	10494 MONTGOMERY RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45242-5214
Country	:	US
Telephone Number	:	513-853-1300
Fax Number	:	513-451-4118

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

Provider Enumeration Date	:	01/02/2019
Last Update Date	:	01/07/2019

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Directions to “ NANCY PACE ” Practice Location

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