Healthcare Provider Details

I. General information

NPI: 1497956486
Provider Name (Legal Business Name): NANCY MCFADDEN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

174 FOXCROFT DR E
PALM HARBOR FL
34683-5609
US

IV. Provider business mailing address

174 FOXCROFT DR E
PALM HARBOR FL
34683-5609
US

V. Phone/Fax

Practice location:
  • Phone: 727-786-8020
  • Fax:
Mailing address:
  • Phone: 727-786-8020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberRN2007342
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: