MEDICARE: NANCY NORDWICK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	156FX1201X	Optometric Assistant Technician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225455819
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY NORDWICK

Provider Business Mailing Address
First Line	:	PO BOX 729
Second Line	:	550 6TH AVE NORTH
City	:	WOLF POINT
State	:	MT
Zip	:	59201-0729
Country	:	US
Telephone Number	:	406-653-5630
Fax Number	:	406-653-3728

Provider Business Practice Location Address
First Line	:	550 6TH AVE NORTH
Second Line	:
City	:	WOLF POINT
State	:	MT
Zip	:	59201-0729
Country	:	US
Telephone Number	:	406-653-5630
Fax Number	:	406-653-3728

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/21/2014
Last Update Date	:	03/21/2014

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Directions to “ NANCY NORDWICK ” Practice Location

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