Provider Demographics
NPI:1043720345
Name:SCANLON, NARA A (RN)
Entity type:Individual
Prefix:
First Name:NARA
Middle Name:A
Last Name:SCANLON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 WASHINGTON AVE. EXT
Mailing Address - Street 2:
Mailing Address - City:SAUGERTIES
Mailing Address - State:NY
Mailing Address - Zip Code:12477-5222
Mailing Address - Country:US
Mailing Address - Phone:845-247-6566
Mailing Address - Fax:845-247-6759
Practice Address - Street 1:30 WASHINGTON AVE. EXT
Practice Address - Street 2:
Practice Address - City:SAUGERTIES
Practice Address - State:NY
Practice Address - Zip Code:12477-5222
Practice Address - Country:US
Practice Address - Phone:845-247-6566
Practice Address - Fax:845-247-6759
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-02
Last Update Date:2017-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY693472163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool