Provider Demographics
NPI:1285455840
Name:BEBB, NANCY K
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:K
Last Name:BEBB
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 1:9097 S ELYRIA RD
Mailing Address - Street 2:
Mailing Address - City:SHREVE
Mailing Address - State:OH
Mailing Address - Zip Code:44676-9733
Mailing Address - Country:US
Mailing Address - Phone:330-465-2138
Mailing Address - Fax:
Practice Address - Street 1:9097 S ELYRIA RD
Practice Address - Street 2:
Practice Address - City:SHREVE
Practice Address - State:OH
Practice Address - Zip Code:44676-9733
Practice Address - Country:US
Practice Address - Phone:330-465-2138
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-17
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant