Individual
MR. NICHOLAS C VANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
660A S MAIN ST, MADISON, WV 25130-1245
(304) 369-4250
(304) 369-8808
Mailing address
660A S MAIN ST, MADISON, WV 25130-1245
(304) 369-4250
(304) 369-8808
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
Q48962
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001754940
MOUNTAIN STATE BLUE SHIEL
WV
01
—
P00290270
RAILROAD MEDICARE
WV
Enumeration date
06/05/2006
Last updated
02/05/2026
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