Provider Demographics
NPI:1083810766
Name:ADINOLFI, NANCY (PA)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:
Last Name:ADINOLFI
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1190 W OLIVE AVE
Mailing Address - Street 2:SUITE L
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95348-1960
Mailing Address - Country:US
Mailing Address - Phone:209-722-0831
Mailing Address - Fax:209-722-0862
Practice Address - Street 1:1190 W OLIVE AVE
Practice Address - Street 2:SUITE L
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95348-1960
Practice Address - Country:US
Practice Address - Phone:209-722-0831
Practice Address - Fax:209-722-0862
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16403363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA16403OtherLICENSE NUMBER