| Doctor Name: | NANCY ANN WALLROFF |
| NPI Number: | 1043283872 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | MA001620L |
| Business Practice Address: | 313 North Street West Middlesex, PA - 16159 |
| Business Phone Number: | 7245282513 |
| Business Fax Number: | 7245288088 |
| Mailing Address: | 150 Christian Ave, HUBBARD |
| State: | OH |
| Postal Code: | 444252008 |
| Phone Number: | 3305347723 |
| Fax Number: | 7245284472 |
| NPI Enumeration Date: | 02/10/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | MA001620L |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |