| Doctor Name: | NANCY WALL |
| NPI Number: | 1316201387 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 255689-1 |
| Business Practice Address: | 99 Main St Delhi, NY - 137531221 |
| Business Phone Number: | 6078325200 |
| Business Fax Number: | |
| Mailing Address: | 6558 River Rd, DOWNSVILLE |
| State: | NY |
| Postal Code: | 137553700 |
| Phone Number: | 6073637327 |
| Fax Number: | |
| NPI Enumeration Date: | 06/25/2012 |
| NPI Last Update Date: | 06/25/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WC0400X |
| License Number: | 255689-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Case Management |
| Taxonomy Definition: | |