Individual
CHRISLINE NICOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
7101 OLD YORK RD, PHILADELPHIA, PA 19126
(610) 584-1000
Mailing address
430 EXTON SQUARE PKWY, UNIT 1417, EXTON, PA 19341-5047
(484) 274-7585
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP017271
PA
Other
Enumeration date
04/18/2017
Last updated
12/30/2022
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