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General NPI Number Information
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NPI Number | 1316555899
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Entity Type | Individual
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Provider Name | NICOLE BENDER
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Gender | Female
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Dates
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Enumeration Date | 07/21/2020
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Last Update Date | 04/11/2022
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Provider Practice Location Address
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Address Line | 620 HOWARD AVE
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City | ALTOONA
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State | PA
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Zip | 16601-4804
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Country | US
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Telephone | 814-889-6157
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Fax |
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Provider Business Mailing Address
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Address Line | 2274 PORTER WAY
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City | LANCASTER
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State | PA
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Zip | 17601-5992
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | MA061656
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License Number State | PA
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