Provider Demographics
NPI:1124065040
Name:REID, NANCY JANE (PNP, RN)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:JANE
Last Name:REID
Suffix:
Gender:F
Credentials:PNP, RN
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:JANE
Other - Last Name:REID-ROBBINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PNP, RN
Mailing Address - Street 1:36 SW NYE ST
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:OR
Mailing Address - Zip Code:97365-3821
Mailing Address - Country:US
Mailing Address - Phone:541-265-4947
Mailing Address - Fax:541-574-6252
Practice Address - Street 1:36 SW NYE ST
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:OR
Practice Address - Zip Code:97365-3821
Practice Address - Country:US
Practice Address - Phone:541-265-4947
Practice Address - Fax:541-574-6252
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR000037688N2 PNP-PP363LC1500X
OR363LC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity Health