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NPI Code Detail

MEDICARE: MRS. NANCY NORDLUND RDH

MEDICARE: MRS. NANCY NORDLUND RDH
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
1124Q00000XDental HygienistH04866AZ

General Provider Information

NPI Number : 1467824938
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. NANCY NORDLUND RDH
Provider Business Mailing Address
First Line : 12096 W HAILEY LN
Second Line :
City : MARANA
State : AZ
Zip : 85653-8648
Country : US
Telephone Number : 520-740-7707
Fax Number : 520-818-3630
Provider Business Practice Location Address
First Line : 340 W PRINCE RD
Second Line :
City : TUCSON
State : AZ
Zip : 85705-6168
Country : US
Telephone Number : 520-740-7707
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/23/2015
Last Update Date : 10/21/2022

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