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General NPI Number Information
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NPI Number | 1417931775
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Entity Type | Individual
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Provider Name | NANCY LYNN WOLTERS CNP
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Gender | Female
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Dates
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Enumeration Date | 11/30/2005
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Last Update Date | 03/24/2016
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Provider Practice Location Address
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Address Line | 801 PRO DR STE A
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City | CELINA
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State | OH
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Zip | 45822-3301
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Country | US
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Telephone | 419-586-3113
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Fax |
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Provider Business Mailing Address
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Address Line | 3650 MENCHHOFER RD
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City | COLDWATER
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State | OH
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Zip | 45828-9749
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Country | US
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Telephone | 419-678-8329
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | NP-08615
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License Number State | OH
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