Ms. Nickola Kim Wallace (CRNP) is a health care provider specializes in Nurse Practitioner.
Practice Location | 1001 S George St, Bldg Mkb, York, PA 17405, US |
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Practice Location Phone | 717-851-2521 |
Practice Location Fax | 717-851-3535 |
Gender | Female |
Specialty In | Nurse Practitioner |
NPI ? | 1326073040 |
Entity Type | Individual |
Enumeration Date ? | Jul 11, 2006 |
Last Update Date ? | Jul 9, 2007 |
Note: NPI: National Provider Identifier issued to health care providers by Centers for Medicare and Medicaid Services (CMS). | |
Specialty | Provider Type | Specialization | License | License State |
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Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | Family | TP006718B | Pennsylvania |
Provider Id | Issuer State | Issuer Type | Issuer |
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50048998 | Pennsylvania | Other | CAPITAL BLUE CROSS |