Healthcare Provider Details

I. General information

NPI: 1376715318
Provider Name (Legal Business Name): NANCY A FICKERT CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2008
Last Update Date: 02/14/2025
Certification Date: 02/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 LIFEMARK DR
SELLERSVILLE PA
18960
US

IV. Provider business mailing address

5 LIFE MARK DR
SELLERSVILLE PA
18960
US

V. Phone/Fax

Practice location:
  • Phone: 215-257-1155
  • Fax: 215-257-7928
Mailing address:
  • Phone: 215-257-1155
  • Fax: 215-257-7928

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberVP006569B
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: