Provider Demographics
NPI:1508899063
Name:NEBEL, KRISTEN M (DO)
Entity type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:M
Last Name:NEBEL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:M
Other - Last Name:GRIFFIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:1762 PIONEER RD
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-1516
Mailing Address - Country:US
Mailing Address - Phone:717-723-8531
Mailing Address - Fax:717-482-0242
Practice Address - Street 1:1762 PIONEER RD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-1516
Practice Address - Country:US
Practice Address - Phone:717-723-8531
Practice Address - Fax:717-482-0242
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-08
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS013415207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000000189639OtherUNISON
PA2768732000OtherINDEPENDENCE BLUE CROSS
PAP008399OtherGATEWAY
PA001900354OtherHIGHMARK
PA20055224OtherMERCY
PA50060215OtherCAPITAL BLUE CROSS/KEYSTONE HEALTH PLAN CENTRAL
PA7936853OtherAETNA-NON HMO
PA1429359OtherAETNA-HMO
PA106597OtherGEISINGER
PA101696290Medicaid
PAP00351031OtherRR MEDICARE
PA2768732000OtherINDEPENDENCE BLUE CROSS
PAP00351031OtherRR MEDICARE