Healthcare Provider Details

I. General information

NPI: 1992624555
Provider Name (Legal Business Name): NANCY MARIE HENRY LVN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5225 TELEGRAPH RD
VENTURA CA
93003-4113
US

IV. Provider business mailing address

515 FOREST PARK BLVD
OXNARD CA
93036-5311
US

V. Phone/Fax

Practice location:
  • Phone: 805-366-1856
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License NumberVN747329
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: