Provider Demographics
NPI:1902874043
Name:DENLEA, NANCY A (MD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:A
Last Name:DENLEA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3025 SHRINE RD
Mailing Address - Street 2:SUITE 190
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31520-4788
Mailing Address - Country:US
Mailing Address - Phone:912-466-7250
Mailing Address - Fax:912-466-7253
Practice Address - Street 1:3025 SHRINE RD
Practice Address - Street 2:SUITE 190
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520-4788
Practice Address - Country:US
Practice Address - Phone:912-466-7250
Practice Address - Fax:912-466-7253
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2016-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA047309207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000861044AMedicaid
GA16BDTJTMedicare ID - Type Unspecified
GAG49372Medicare UPIN