Provider Demographics
NPI:1770546582
Name:BLEAM, NANCY KAY (ATC-RET, OTC)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:KAY
Last Name:BLEAM
Suffix:
Gender:F
Credentials:ATC-RET, OTC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 ATLANTIC AVE
Mailing Address - Street 2:UNIT 3
Mailing Address - City:HULL
Mailing Address - State:MA
Mailing Address - Zip Code:02045-3060
Mailing Address - Country:US
Mailing Address - Phone:603-762-2470
Mailing Address - Fax:
Practice Address - Street 1:300 LONGWOOD AVE
Practice Address - Street 2:10 NW, ROOM 1079
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5724
Practice Address - Country:US
Practice Address - Phone:617-355-7468
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer