Provider Demographics
NPI:1851077234
Name:NICHILO, KATELYN MICHELLE (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:KATELYN
Middle Name:MICHELLE
Last Name:NICHILO
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 SAYLONG DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15235-4326
Mailing Address - Country:US
Mailing Address - Phone:814-558-6372
Mailing Address - Fax:
Practice Address - Street 1:741 LOCUST AVE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-2735
Practice Address - Country:US
Practice Address - Phone:724-906-4798
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-22
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP028227363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily