Provider Demographics
NPI:1518391663
Name:NICKLES, NANCY D'AMICO (MD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:D'AMICO
Last Name:NICKLES
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:570-271-6578
Practice Address - Street 1:16 WOODBINE LN
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:PA
Practice Address - Zip Code:17821-8029
Practice Address - Country:US
Practice Address - Phone:570-271-5600
Practice Address - Fax:570-271-5851
Is Sole Proprietor?:No
Enumeration Date:2013-08-26
Last Update Date:2020-08-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD424757208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics