MEDICARE: NIKOLE DONMOYER PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	1221345	PA

General Provider Information

NPI Number	:	1376350835
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NIKOLE DONMOYER PA-C

Provider Business Mailing Address
First Line	:	4600 CROSSINGS BLVD # E403
Second Line	:
City	:	LANCASTER
State	:	PA
Zip	:	17601-2064
Country	:	US
Telephone Number	:	706-575-7948
Fax Number	:

Provider Business Practice Location Address
First Line	:	2112 HARRISBURG PIKE # 202
Second Line	:
City	:	LANCASTER
State	:	PA
Zip	:	17601-2644
Country	:	US
Telephone Number	:	706-575-7948
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/17/2024
Last Update Date	:	04/13/2026

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Directions to “ NIKOLE DONMOYER PA-C” Practice Location

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