Healthcare Provider Details

I. General information

NPI: 1528972908
Provider Name (Legal Business Name): NICOLE MENGES-MEYERS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

413 GRANITE RUN DR
LANCASTER PA
17601-6809
US

IV. Provider business mailing address

743 SKIP LN
LANCASTER PA
17602-7205
US

V. Phone/Fax

Practice location:
  • Phone: 717-925-2900
  • Fax:
Mailing address:
  • Phone: 610-248-5590
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN707582
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: