Individual
NICOLE E MYERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
120 N 7TH ST STE 101, CHAMBERSBURG, PA 17201-1795
(717) 263-1220
(717) 263-6255
Mailing address
785 5TH AVE, SUITE 3, CHAMBERSBURG, PA 17201-4232
(717) 263-9555
(717) 217-4218
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
MA052694
PA
363AS0400X
Surgical Physician Assistant
Primary
MA052694
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103146271
—
PA
01
—
50063906
CAPITAL BC
PA
01
—
50074345
CAPITAL BLUE CROSS
PA
01
—
50111454
CAPITAL BLUE CROSS
PA
01
—
50111456
CAPITAL BLUE CROSS
PA
01
—
6622483
AETNA HMO
PA
01
—
8552892
AETNA HMO
PA
01
—
8552893
AETNA HMO
PA
01
—
867633
MEDICARE GROUP #
PA
01
—
9715533
AETNA NON HMO
PA
01
—
MA052694
LICENSE
PA
Enumeration date
09/28/2006
Last updated
03/07/2023
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