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Ms. Nickola Kim Wallace, CRNP
Family Nurse Practitioner in York, Pennsylvania
NPI 1326073040

Nickola Kim Wallace is a Family Nurse Practitioner based in York, PA and is specialized in Family. Nickola Kim Wallace practices in York, PA and has the professional credentials of CRNP. The NPI Number for Nickola Kim Wallace is 1326073040 and holds a License No. TP006718B (Pennsylvania).

The current practice location address for Nickola Kim Wallace is 1001 S George St, York, PA and can be reached out via phone at 717-851-2521 and via fax at 717-851-3535.

Location: 1001 S George St, York, PA, 17403-3026
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1326073040
Provider Name
Nickola Kim Wallace
Credential
CRNP
Provider Entity Type
Individual
Gender
Female
Address
1001 S George St, York, PA, 17403-3026
Phone Number
717-851-2521
Fax Number
717-851-3535
Provider Enumeration Date
07/11/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
50048998 01 PA CAPITAL BLUE CROSS
institution
Provider Business Practice Location Address Details
Address
1001 S George St
City
York
State
Pennsylvania
Zip
17405
Phone Number
717-851-2521
Fax Number
717-851-3535
person
Provider Business Mailing Address Details
Address
1001 S George St
City
York
State
Pennsylvania
Zip
17405
Phone Number
717-851-2521
Fax Number
717-851-3535
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
TP006718B (Pennsylvania)
Definition
Definition to come...
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