Healthcare Provider Details

I. General information

NPI: 1821072786
Provider Name (Legal Business Name): NANCY S. CANGANY M.S., L.G.C., C.G.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2005
Last Update Date: 07/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8091 TOWNSHIP LINE RD SUITE 108
INDIANAPOLIS IN
46260-2494
US

IV. Provider business mailing address

5712 SHARON RD
INDIANAPOLIS IN
46228-1913
US

V. Phone/Fax

Practice location:
  • Phone: 317-415-7741
  • Fax: 317-415-7734
Mailing address:
  • Phone: 317-415-7741
  • Fax: 317-415-7734

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number74000003A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: