Healthcare Provider Details

I. General information

NPI: 1043115017
Provider Name (Legal Business Name): NICHOLAS G ROCKWELL NREMT EMT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

511 BEDFORD PL
LITITZ PA
17543-6400
US

IV. Provider business mailing address

511 BEDFORD PL
LITITZ PA
17543-6400
US

V. Phone/Fax

Practice location:
  • Phone: 717-892-9288
  • Fax:
Mailing address:
  • Phone: 717-892-9288
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License NumberE4071549
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: