Provider Demographics
NPI:1730264136
Name:NITSCH, NANCY KAY (DC, MTAA)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:KAY
Last Name:NITSCH
Suffix:
Gender:F
Credentials:DC, MTAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10726 HIGHWAY 21
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:MO
Mailing Address - Zip Code:63050-5075
Mailing Address - Country:US
Mailing Address - Phone:636-789-2202
Mailing Address - Fax:
Practice Address - Street 1:10726 HIGHWAY 21
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:MO
Practice Address - Zip Code:63050-5075
Practice Address - Country:US
Practice Address - Phone:636-789-2202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO5101111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO103223OtherHEALTH LINK
MO11138OtherBLUE CROSS BLUE SHEILD
MOT43483Medicare UPIN