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NPI Code Detail

MEDICARE: NANCY J CHRISTIE BA

MEDICARE: NANCY J CHRISTIE BA
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
1171M00000XCase Manager/Care Coordinator1057 120WI

General Provider Information

NPI Number : 1265655104
Entity Type Code : Individual
Provider Name (Legal Business Name) : NANCY J CHRISTIE BA
Provider Business Mailing Address
First Line : 532 ROUND LAKE LN
Second Line :
City : OSCEOLA
State : WI
Zip : 54020-5431
Country : US
Telephone Number : 715-755-3008
Fax Number :
Provider Business Practice Location Address
First Line : 100 POLK COUNTY PLZ
Second Line : SUITE 50
City : BALSAM LAKE
State : WI
Zip : 54810-9071
Country : US
Telephone Number : 715-485-8467
Fax Number : 715-485-8490
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2007
Last Update Date : 07/08/2007

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Directions to “ NANCY J CHRISTIE BA” Practice Location

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