Healthcare Provider Details

I. General information

NPI: 1285191858
Provider Name (Legal Business Name): NICOLE ANN BRICE CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2019
Last Update Date: 01/05/2023
Certification Date: 01/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 E MARSHALL ST
WEST CHESTER PA
19380-4412
US

IV. Provider business mailing address

701 E MARSHALL ST
WEST CHESTER PA
19380-4412
US

V. Phone/Fax

Practice location:
  • Phone: 610-431-5000
  • Fax:
Mailing address:
  • Phone: 610-431-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberSP019838
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: