Healthcare Provider Details

I. General information

NPI: 1548165632
Provider Name (Legal Business Name): NANCY ERMERT RN,BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44927 W HATHAWAY AVE
MARICOPA AZ
85139
US

IV. Provider business mailing address

PO BOX 804
MARICOPA AZ
85139-0297
US

V. Phone/Fax

Practice location:
  • Phone: 928-923-6036
  • Fax: 520-350-7077
Mailing address:
  • Phone: 928-923-6036
  • Fax: 520-350-7077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN186050
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: