Nicole Brianne Theofanis, PA-C

NPI #1720467897 in Wormleysburg, Pennsylvania

Provider Information

NPI Number: 1720467897
Entity Type: Individual
Name: Nicole Brianne Theofanis, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: May 22, 2015
Last Updated: Jun 26, 2019

Practice Location

Address: 1000 N FRONT ST
City: Wormleysburg
State: Pennsylvania
ZIP Code: 17043-1021
Phone: (717) 731-0101

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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