Provider Demographics
NPI:1992379606
Name:FOREY, NANETTE MICHELLE
Entity type:Individual
Prefix:
First Name:NANETTE
Middle Name:MICHELLE
Last Name:FOREY
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 1:23122 SILVER CHALICE
Mailing Address - Street 2:
Mailing Address - City:ELMENDORF
Mailing Address - State:TX
Mailing Address - Zip Code:78112-6058
Mailing Address - Country:US
Mailing Address - Phone:210-621-4034
Mailing Address - Fax:
Practice Address - Street 1:23122 SILVER CHALICE
Practice Address - Street 2:
Practice Address - City:ELMENDORF
Practice Address - State:TX
Practice Address - Zip Code:78112-6058
Practice Address - Country:US
Practice Address - Phone:210-621-4034
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-17
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX787268163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics