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Individual
DR. JULIE PANDORA NICKLES
Active
Individual
DR. JULIE PANDORA NICKLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS004879L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02713300
CAPITAL BLUE CROSS
PA
01
—
0459530
AETNA
PA
01
—
22143
GEISINGER HEALTH PLAN
PA
01
—
2713300
KHP CENTRAL
PA
01
—
431452
CAPITAL BLUE SHIELD
PA
Enumeration date
07/05/2006
Last updated
03/13/2024
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