Provider Demographics
NPI:1174111033
Name:MAY, NICOLE
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:MAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:
Other - Last Name:FELDMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:33 E PEARL ST UNIT A
Mailing Address - Street 2:
Mailing Address - City:ALBION
Mailing Address - State:PA
Mailing Address - Zip Code:16401-1142
Mailing Address - Country:US
Mailing Address - Phone:814-218-0403
Mailing Address - Fax:
Practice Address - Street 1:33 E PEARL ST UNIT A
Practice Address - Street 2:
Practice Address - City:ALBION
Practice Address - State:PA
Practice Address - Zip Code:16401-1142
Practice Address - Country:US
Practice Address - Phone:814-218-0403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-06
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA33223601251E00000X, 372600000X, 385H00000X, 374U00000X
253Z00000X, 374K00000X, 374T00000X, 376J00000X
33223601372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No372600000XNursing Service Related ProvidersAdult Companion
No374K00000XNursing Service Related ProvidersReligious Nonmedical Practitioner
No374T00000XNursing Service Related ProvidersReligious Nonmedical Nursing Personnel
No376J00000XNursing Service Related ProvidersHomemaker
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103130404Medicaid