Provider Demographics
NPI:1316251861
Name:SCHWARTZ, NICOLE M (MSN, CRNP, MSW, LSW)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:M
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:MSN, CRNP, MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87 S GRANT ST
Mailing Address - Street 2:
Mailing Address - City:MANHEIM
Mailing Address - State:PA
Mailing Address - Zip Code:17545-1805
Mailing Address - Country:US
Mailing Address - Phone:267-205-5612
Mailing Address - Fax:717-927-0303
Practice Address - Street 1:1166 HILTS RD
Practice Address - Street 2:
Practice Address - City:WRIGHTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17368-9205
Practice Address - Country:US
Practice Address - Phone:888-526-6728
Practice Address - Fax:305-891-4228
Is Sole Proprietor?:No
Enumeration Date:2010-07-27
Last Update Date:2024-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW135173104100000X
PASP028829363LP0808X, 363LP0808X
PARN719772163WP0808X
176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No176B00000XOther Service ProvidersMidwife