Provider Demographics
NPI:1902876501
Name:PACO, NANNETTE MARIA (PT)
Entity Type:Individual
Prefix:MS
First Name:NANNETTE
Middle Name:MARIA
Last Name:PACO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MRS
Other - First Name:NANNETTE
Other - Middle Name:MARIA
Other - Last Name:PACO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:PSC 482 BOX 3059
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96362
Mailing Address - Country:US
Mailing Address - Phone:01181611-743-7555
Mailing Address - Fax:
Practice Address - Street 1:UNITED STATES NAVAL HOSPITAL
Practice Address - Street 2:PSC 482
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96362
Practice Address - Country:US
Practice Address - Phone:0118131-143-7555
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19579225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist