Healthcare Provider Details

I. General information

NPI: 1174610109
Provider Name (Legal Business Name): NANCY ELIZABETH WERNZ RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 04/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1791 ALUM CREEK DR
COLUMBUS OH
43207-1708
US

IV. Provider business mailing address

1105 SCHROCK RD STE 130
COLUMBUS OH
43229-1174
US

V. Phone/Fax

Practice location:
  • Phone: 614-445-8131
  • Fax:
Mailing address:
  • Phone: 614-431-3655
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License NumberRN-260975
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License NumberRN.260975
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: