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Individual

MRS. NICOLE COPPOLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS,RD,LDN

Contact information

Practice address
1111 E END BLVD, WILKES BARRE, PA 18711-0030
(570) 824-3521
(570) 281-5392
Mailing address
429 2ND ST, BLAKELY, PA 18447-1217
(570) 709-0132

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN001145
PA
163W00000X
Registered Nurse
RN812183
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
820667
BCNEPA
PA
Enumeration date
02/15/2007
Last updated
03/30/2026
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