Provider Demographics
NPI:1861690810
Name:PRECHTL, NANCY VIRGINIA (DPM)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:VIRGINIA
Last Name:PRECHTL
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 LOWELL ST STE 102
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01880-1984
Mailing Address - Country:US
Mailing Address - Phone:781-224-3668
Mailing Address - Fax:817-224-3667
Practice Address - Street 1:380 LOWELL ST STE 102
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:MA
Practice Address - Zip Code:01880-1984
Practice Address - Country:US
Practice Address - Phone:781-224-3668
Practice Address - Fax:812-243-6677
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2306213ES0131X, 213ES0103X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
4510094OtherAETNA
MA99448901OtherNETWORK HEALTH
MA110076993AMedicaid
205191632OtherUNICARE/GIC
205191632OtherUNITED HEALTHCARE
MA496781OtherTUFTS
0043548OtherNEIGHBORHOOD HEALTH PLAN
95543405OtherNETWORK HEALTH
Y71141OtherBLUE CROSS BLUE SHIELD
205191632OtherCOMMONWEALTH INDEMNITY
7776024OtherCIGNA
4510094OtherAETNA
MA99448901OtherNETWORK HEALTH
0043548OtherNEIGHBORHOOD HEALTH PLAN