Healthcare Provider Details

I. General information

NPI: 1235064262
Provider Name (Legal Business Name): NICOLE LYNN YOST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 GREENWOOD AVE STE 140
JENKINTOWN PA
19046-2649
US

IV. Provider business mailing address

500 BELFAST RD
NAZARETH PA
18064-9281
US

V. Phone/Fax

Practice location:
  • Phone: 973-241-1356
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberSP036170
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: