Provider Demographics
NPI:1164518262
Name:VALLOTTON, ANNE M (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:M
Last Name:VALLOTTON
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:MRS
Other - First Name:ANNE
Other - Middle Name:M
Other - Last Name:VALLOTTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NURSE PRACTITIONER
Mailing Address - Street 1:1861 POWDER MILL RD
Mailing Address - Street 2:ATTN MEDICAL STAFF OFFICE
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-4723
Mailing Address - Country:US
Mailing Address - Phone:717-718-2000
Mailing Address - Fax:717-741-9867
Practice Address - Street 1:470 EISENHOWER DR
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-5248
Practice Address - Country:US
Practice Address - Phone:717-633-0031
Practice Address - Fax:717-632-1085
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATP003184C363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102778881Medicaid