Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | CH0006794 | FL |
N | 111NN1001X | Nutrition | CH0006794 | FL |
NPI | 1023042330 |
---|---|
Provider Name | Dr. Nancy I Irven |
First Address | Crystal River, FL 34429-8011 |
Second Address | Crystal River, FL 34429-8011 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 09/09/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U51768 | (02) | FL |