Provider Demographics
NPI:1174992515
Name:GEHMAN, NICHOLE (CRNP)
Entity type:Individual
Prefix:
First Name:NICHOLE
Middle Name:
Last Name:GEHMAN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5275 LINCOLN HWY
Mailing Address - Street 2:
Mailing Address - City:GAP
Mailing Address - State:PA
Mailing Address - Zip Code:17527-9427
Mailing Address - Country:US
Mailing Address - Phone:717-442-8111
Mailing Address - Fax:717-442-8981
Practice Address - Street 1:5275 LINCOLN HWY
Practice Address - Street 2:
Practice Address - City:GAP
Practice Address - State:PA
Practice Address - Zip Code:17527-9427
Practice Address - Country:US
Practice Address - Phone:717-442-8111
Practice Address - Fax:717-442-8981
Is Sole Proprietor?:No
Enumeration Date:2015-09-16
Last Update Date:2015-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN577958163W00000X
PASP015492363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse