Individual
LARRY ALLEN NANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7915 LAKE MANASSAS DRIVE, SUTIE 205, GAINESVILLE, NC 20155-3260
(866) 755-3551
(703) 365-7702
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(866) 775-3551
(703) 365-7702
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
0101037658
VA
207V00000X
Obstetrics & Gynecology Physician
Primary
0101037658
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006213987
—
VA
Enumeration date
08/11/2005
Last updated
02/11/2014
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