Provider Demographics
NPI:1366414914
Name:POST, NICOLE J (DO)
Entity type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:J
Last Name:POST
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 S 2ND ST STE 2F
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17104-1612
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3141 CAPE HORN RD
Practice Address - Street 2:
Practice Address - City:RED LION
Practice Address - State:PA
Practice Address - Zip Code:17356-9071
Practice Address - Country:US
Practice Address - Phone:717-246-5180
Practice Address - Fax:717-246-2005
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2017-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS009798L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001808052Medicaid
PA039846OtherGROUP PTAN
PA001808052Medicaid
PA039163N84Medicare ID - Type Unspecified
PAH19879Medicare UPIN