Healthcare Provider Details

I. General information

NPI: 1932194008
Provider Name (Legal Business Name): NANCY K STORMER CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2005
Last Update Date: 12/03/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 N FRONT ST # 2
PHILIPSBURG PA
16866-1606
US

IV. Provider business mailing address

886 GALEN DR
STATE COLLEGE PA
16803-1164
US

V. Phone/Fax

Practice location:
  • Phone: 814-342-6992
  • Fax: 814-342-1770
Mailing address:
  • Phone: 814-342-6992
  • Fax: 814-342-1770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberSP008750
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: