Provider Demographics
NPI:1285696237
Name:OZMENT, NANCI ANNE (CRNA)
Entity type:Individual
Prefix:
First Name:NANCI
Middle Name:ANNE
Last Name:OZMENT
Suffix:
Gender:F
Credentials:CRNA
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 6002
Mailing Address - Street 2:
Mailing Address - City:URBANA
Mailing Address - State:IL
Mailing Address - Zip Code:61803-6002
Mailing Address - Country:US
Mailing Address - Phone:217-326-8630
Mailing Address - Fax:
Practice Address - Street 1:602 W. UNIVERSITY AVENUE
Practice Address - Street 2:ANESTHESIOLOGY
Practice Address - City:URBANA
Practice Address - State:IL
Practice Address - Zip Code:61801
Practice Address - Country:US
Practice Address - Phone:217-383-3141
Practice Address - Fax:217-383-3265
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209000790367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILIL3270129Medicare PIN
K07724Medicare ID - Type Unspecified
IL6447860011Medicare NSC