Healthcare Provider Details

I. General information

NPI: 1639255219
Provider Name (Legal Business Name): NANCY JEAN PELFREY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NANCY JEAN OSBORNE

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 10/27/2021
Certification Date: 10/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

267 W MERRICK RD SECOND FLOOR
FREEPORT NY
11520-3346
US

IV. Provider business mailing address

1832 CENTRE POINT CIR SUITE 106
NAPERVILLE IL
60563-1438
US

V. Phone/Fax

Practice location:
  • Phone: 516-379-5000
  • Fax:
Mailing address:
  • Phone: 630-245-0339
  • Fax: 866-594-9002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPN05217
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number5010456
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: