Healthcare Provider Details

I. General information

NPI: 1629647011
Provider Name (Legal Business Name): NANCY ANN MAIER RN, PMHCNS-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NANCY ANN VIOLASSE RN, PMHCNS-BC

II. Dates (important events)

Enumeration Date: 06/21/2021
Last Update Date: 06/21/2021
Certification Date: 06/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2207 MOUNT ROYAL DR
CASTLE ROCK CO
80104-2738
US

IV. Provider business mailing address

2207 MOUNT ROYAL DR
CASTLE ROCK CO
80104-2738
US

V. Phone/Fax

Practice location:
  • Phone: 310-922-5852
  • Fax:
Mailing address:
  • Phone: 310-922-5852
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number268884
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: