Provider Demographics
NPI:1104136217
Name:GLEASON, NANCY J (RN)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:J
Last Name:GLEASON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 95
Mailing Address - Street 2:
Mailing Address - City:RHINEBECK
Mailing Address - State:NY
Mailing Address - Zip Code:12572-0095
Mailing Address - Country:US
Mailing Address - Phone:845-235-6778
Mailing Address - Fax:
Practice Address - Street 1:57 SOUTH ST
Practice Address - Street 2:
Practice Address - City:RHINEBECK
Practice Address - State:NY
Practice Address - Zip Code:12572-1715
Practice Address - Country:US
Practice Address - Phone:845-235-6778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-08
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY409627-1163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health