Provider Demographics
NPI:1831141159
Name:CLAPPER, NICOLE L (DO)
Entity Type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:L
Last Name:CLAPPER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:NICOLE
Other - Middle Name:L
Other - Last Name:ROSSMAN-CLAPPER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:1086 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15905-4305
Mailing Address - Country:US
Mailing Address - Phone:814-410-8300
Mailing Address - Fax:814-410-8331
Practice Address - Street 1:188 INDUSTRIAL PARK RD
Practice Address - Street 2:SUITE B
Practice Address - City:EBENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15931-4125
Practice Address - Country:US
Practice Address - Phone:814-471-9005
Practice Address - Fax:814-471-9007
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2014-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS013837207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA139765Medicare PIN