1982856506 NPI number — DR. NANCY WILLIAMS NAGEL PSY.D.

Table of content: DR. NANCY WILLIAMS NAGEL PSY.D. (NPI 1982856506)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982856506 NPI number — DR. NANCY WILLIAMS NAGEL PSY.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NAGEL
Provider First Name:
NANCY
Provider Middle Name:
WILLIAMS
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PSY.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RUDWALL
Provider Other First Name:
NANCY
Provider Other Middle Name:
ELLEN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1982856506
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/14/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
715 WOODBINE AVE
Provider Second Line Business Mailing Address:
CINCINNATI
Provider Business Mailing Address City Name:
CINCINNATI
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45246-4518
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-703-9195
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3200 VINE ST
Provider Second Line Business Practice Location Address:
CINCINNATI
Provider Business Practice Location Address City Name:
CINCINNATI
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45220-2213
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-861-3100
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/14/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TH0004X , with the licence number:  6487 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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