Provider Demographics
NPI:1225879968
Name:ROOS, NANCY N
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:N
Last Name:ROOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3614 HAZELHURST AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43612-1021
Mailing Address - Country:US
Mailing Address - Phone:253-883-8794
Mailing Address - Fax:
Practice Address - Street 1:3614 HAZELHURST AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43612-1021
Practice Address - Country:US
Practice Address - Phone:253-883-8794
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty