MS. NICKOLA KIM WALLACE CRNP NPI 1326073040

NPI Information

  • NPI: 1326073040
  • Provider Name: MS. NICKOLA KIM WALLACE, CRNP
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • Address: 1001 S GEORGE ST
    BLDG MKB
    YORK, PA
    ZIP 17405
  • Phone: (717) 851-2521

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NPI Details

MS. Nickola Kim Wallace, CRNP is a family nurse practitioner in York, PA. MS. Nickola Kim Wallace, CRNP NPI is 1326073040. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1001 S GEORGE ST
BLDG MKB
YORK, PA
ZIP 17405
Phone: (717) 851-2521
Fax: (717) 851-3535

The enumeration date for this NPI number is 7/11/2006 and was last updated on 7/9/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamilyTP006718BPENNSYLVANIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
150048998OTHERPENNSYLVANIACAPITAL BLUE CROSS
2050483EZ3MEDICARE ID-TYPE UNSPECIFIEDPENNSYLVANIAPA MEDICARE
3P38551MEDICARE UPINPENNSYLVANIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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