Provider Demographics
NPI:1467246215
Name:NUCKOLES, STORMI
Entity type:Individual
Prefix:
First Name:STORMI
Middle Name:
Last Name:NUCKOLES
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 PARK RD
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22802-2404
Mailing Address - Country:US
Mailing Address - Phone:540-432-4243
Mailing Address - Fax:
Practice Address - Street 1:1200 PARK RD
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22802-2404
Practice Address - Country:US
Practice Address - Phone:540-432-4243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program