Individual
NICOLE DENISE GRAY YODER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
709 DELAWARE AVE, FOUNTAIN HILL, PA 18015-1107
(610) 954-3890
(610) 954-3046
Mailing address
709 DELAWARE AVE, FOUNTAIN HILL, PA 18015-1107
(610) 954-3890
(610) 954-3046
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
OS013307
PA
207RP1001X
Pulmonary Disease Physician
Primary
OS013307
PA
Other
Enumeration date
05/18/2007
Last updated
09/19/2012
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