Provider Demographics
NPI:1871570689
Name:HAITZ, NANCY (RN,CPNP)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:
Last Name:HAITZ
Suffix:
Gender:F
Credentials:RN,CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 BATAVIA CITY CTR
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:NY
Mailing Address - Zip Code:14020-2107
Mailing Address - Country:US
Mailing Address - Phone:585-343-2611
Mailing Address - Fax:585-343-3826
Practice Address - Street 1:47 BATAVIA CITY CTR
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:NY
Practice Address - Zip Code:14020-2146
Practice Address - Country:US
Practice Address - Phone:585-343-2611
Practice Address - Fax:585-343-3826
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF3809181173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine