Healthcare Provider Details

I. General information

NPI: 1700864394
Provider Name (Legal Business Name): NANCY JOAN BENDER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 UNIVERSITY AVE
SACRAMENTO CA
95825-6504
US

IV. Provider business mailing address

500 UNIVERSITY AVE
SACRAMENTO CA
95825-6504
US

V. Phone/Fax

Practice location:
  • Phone: 916-830-2000
  • Fax:
Mailing address:
  • Phone: 916-830-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberFNP9914
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: