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General NPI Number Information
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NPI Number | 1275953408
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Entity Type | Individual
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Provider Name | NANCY S SAMPLE CNS
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Gender | Female
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Dates
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Enumeration Date | 04/28/2014
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 7630 RIVERS EDGE DR
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City | COLUMBUS
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State | OH
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Zip | 43235-1329
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Country | US
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Telephone | 614-533-4998
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Fax | 614-533-4045
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Provider Business Mailing Address
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Address Line | PO BOX 7527
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City | DUBLIN
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State | OH
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Zip | 43017-0727
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN.186505
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 364SA2200X
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Taxonomy Name | Adult Health Clinical Nurse Specialist
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License Number | COA.16623-NS
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License Number State | OH
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