Provider Demographics
NPI:1437362639
Name:HERRERA, NANCY BEATRIZ (PT)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:BEATRIZ
Last Name:HERRERA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 DOGWOOD LN
Mailing Address - Street 2:
Mailing Address - City:MARTIN
Mailing Address - State:TN
Mailing Address - Zip Code:38237-8638
Mailing Address - Country:US
Mailing Address - Phone:731-676-1565
Mailing Address - Fax:
Practice Address - Street 1:640 HANNINGS LN
Practice Address - Street 2:
Practice Address - City:MARTIN
Practice Address - State:TN
Practice Address - Zip Code:38237-3308
Practice Address - Country:US
Practice Address - Phone:731-587-3193
Practice Address - Fax:731-588-2732
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPT0000004350225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist