Provider Demographics
NPI:1588074942
Name:DINGLER, NANCY S (CRNP)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:S
Last Name:DINGLER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 300
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17042-0300
Mailing Address - Country:US
Mailing Address - Phone:717-270-7780
Mailing Address - Fax:717-274-9746
Practice Address - Street 1:618 CORNWALL RD
Practice Address - Street 2:BUILDING 2
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-7089
Practice Address - Country:US
Practice Address - Phone:717-279-6700
Practice Address - Fax:717-279-6759
Is Sole Proprietor?:No
Enumeration Date:2014-05-06
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP013835363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PASP013835OtherLICENSE
PA102938072 0001Medicaid
PA360688PUDMedicare PIN