Individual
J MARK NISLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
500 UNIVERSITY DR, HERSHEY, PA 17033-2360
(717) 531-0000
Mailing address
3148 LINCOLN HWY E, PARADISE, PA 17562-9601
(620) 694-7624
Taxonomy
Speciality
Code
Description
License number
State
363LC0200X
Critical Care Medicine Nurse Practitioner
Primary
SP026545
PA
Other
Enumeration date
01/24/2023
Last updated
04/06/2023
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