Individual
DR. NICOLE MARIE OSEVALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1120 COCOA AVE, HERSHEY, PA 17033
(717) 533-4141
(717) 533-9797
Mailing address
P.O. BOX 858, CA410, HERSHEY, PA 17033-0858
(800) 243-1455
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD436859
PA
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
MD436859
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023075470002
—
PA
Enumeration date
03/25/2007
Last updated
04/13/2021
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