Healthcare Provider Details

I. General information

NPI: 1164518262
Provider Name (Legal Business Name): ANNE M VALLOTTON NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNE M VALLOTTON NURSE PRACTITIONER

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 05/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

470 EISENHOWER DR
HANOVER PA
17331-5248
US

IV. Provider business mailing address

1861 POWDER MILL RD ATTN MEDICAL STAFF OFFICE
YORK PA
17402-4723
US

V. Phone/Fax

Practice location:
  • Phone: 717-633-0031
  • Fax: 717-632-1085
Mailing address:
  • Phone: 717-718-2000
  • Fax: 717-741-9867

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberTP003184C
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: