Provider Demographics
NPI:1912795782
Name:DEPALMA, NANCY EILEEN (RN, BSN)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:EILEEN
Last Name:DEPALMA
Suffix:
Gender:
Credentials:RN, BSN
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:EILEEN
Other - Last Name:DRAVING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, BSN
Mailing Address - Street 1:24533 SANTA CLARA AVENUE
Mailing Address - Street 2:
Mailing Address - City:DANA POINT
Mailing Address - State:CA
Mailing Address - Zip Code:92629-3032
Mailing Address - Country:US
Mailing Address - Phone:949-424-9902
Mailing Address - Fax:
Practice Address - Street 1:24533 SANTA CLARA AVENUE
Practice Address - Street 2:
Practice Address - City:DANA POINT
Practice Address - State:CA
Practice Address - Zip Code:92629-3032
Practice Address - Country:US
Practice Address - Phone:949-424-9902
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN366258163WH0200X, 163WP1700X, 163WM0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WM0102XNursing Service ProvidersRegistered NurseMaternal NewbornGroup - Multi-Specialty
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty
No163WP1700XNursing Service ProvidersRegistered NursePerinatalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARN366258Medicaid