Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 200950055NP | OR |
NPI | 1013029412 |
---|---|
Provider Name | Ms. Nancy Novig |
First Address | Portland, OR 97232-2023 |
Second Address | Clackamas, OR 97015-8970 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 25/11/2018 |