Provider Demographics
NPI:1144668369
Name:NUSBAUM, NANCY (RN)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:NUSBAUM
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1412 17TH ST
Mailing Address - Street 2:SUITE 310
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-5211
Mailing Address - Country:US
Mailing Address - Phone:661-335-7700
Mailing Address - Fax:
Practice Address - Street 1:1412 17TH ST
Practice Address - Street 2:SUITE 310
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-5211
Practice Address - Country:US
Practice Address - Phone:661-335-7700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-10
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA271568163W00000X, 163WC0400X, 171M00000X, 251B00000X, 347C00000X, 3747P1801X, 374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163W00000XNursing Service ProvidersRegistered Nurse
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No251B00000XAgenciesCase Management
No347C00000XTransportation ServicesPrivate Vehicle
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No374U00000XNursing Service Related ProvidersHome Health Aide