Provider Demographics
NPI:1881751923
Name:CARROLL, NANCY ANN (NP)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:ANN
Last Name:CARROLL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 SEARCH AVE
Mailing Address - Street 2:
Mailing Address - City:PENNINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08534-3512
Mailing Address - Country:US
Mailing Address - Phone:609-730-0973
Mailing Address - Fax:
Practice Address - Street 1:1205 LANGHORNE NEWTOWN RD STE 311
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1222
Practice Address - Country:US
Practice Address - Phone:215-750-1626
Practice Address - Fax:215-750-9359
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00035200363LF0000X
PASP007776363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily