Individual
NICOLE LAURA REICHNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
3998 RED LION RD, EMERGENCY MEDICINE, PHILADELPHIA, PA 19114-1436
(215) 612-4000
(215) 807-8235
Mailing address
PO BOX 8500-6335, PHILADELPHIA, PA 19178-0001
(215) 807-8000
(215) 807-8235
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
SP008072
PA
363L00000X
Nurse Practitioner
SP008072
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1667661
HIGHMARK BLUE SHIELD
PA
01
—
P00351745
RAILROAD MEDICARE
PA
Enumeration date
09/20/2005
Last updated
08/24/2007
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