LORI NICOLE BRACKBILL (NPI# 1881971927) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881971927 |
| Entity Type | Individual |
| Full Name | LORI NICOLE BRACKBILL |
| Credential | PA-C |
| Practice Address |
25 Monument Rd Ste 190 York PA 17403-5059 |
| Mailing Address |
3421 Concord Rd York PA 17402-9001 |
| Practice Telephone | 7178516454 |
| Practice Fax Number | 7178511665 |
| Mailing Telephone | 7178516454 |
| Mailing Fax Number | 7178511665 |
| Enumeration Date | 2011-11-03 |
| Last Update Date | 2018-01-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
MA055163 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | GATEWAY MEDICARE ASSURED | 1603241 | 01 |
| PA | HIGHMARK BLUE SHIELD - FREEDOM BLUE | 2678804 | 01 |
| Street Address |
25 MONUMENT RD STE 190 |
| City | YORK |
| State | PA |
| Zip Code | 17403-5059 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114074424 | Norman Scott Yoder | Physician Assistant | 25 Monument Rd Ste 190, York, PA 17403-5059 | 2007-01-05 |
| 1891260477 | Misty Lynn Ostasewski | Nurse Practitioner | 25 Monument Rd Ste 190, York, PA 17403-5059 | 2018-10-10 |
| 1336664382 | Mariannette Calon-munoz | Nurse Practitioner | 25 Monument Rd Ste 190, York, PA 17403-5059 | 2017-08-11 |
| 1104221415 | Stephanie Ann Sanders | Nurse Practitioner | 25 Monument Rd Ste 190, York, PA 17403-5059 | 2014-10-29 |
| 1730598053 | Sedney Pabon | Nurse Practitioner | 25 Monument Rd Ste 190, York, PA 17403-5059 | 2014-08-12 |
| 1023441391 | Linda T Farjo | Nurse Practitioner | 25 Monument Rd Ste 190, York, PA 17403-5059 | 2013-08-09 |
| 1992097562 | Scott Tiedebohl | Surgery | 25 Monument Rd Ste 190, York, PA 17403-5059 | 2011-05-13 |
| 1790003093 | Oluwafunmi Onaopemipo Awonuga | Surgery | 25 Monument Rd Ste 190, York, PA 17403-5059 | 2010-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679113286 | Maria Frances Defelice | Social Worker | 1902 Woodland Rd, York, PA 17403 | 2020-01-11 |
| 1710524335 | White Deer Run LLC | Community/Behavioral Health | 257 E Market Street, 2nd Floor, York, PA 17403 | 2019-12-02 |
| 1275016917 | Laura Anne Wanenchak | Speech-Language Pathologist | Genesis Rehab Services, 2760 Pine Grove Road, York, PA 17403 | 2018-09-10 |
| 1306355771 | Emily Good | Occupational Therapist | 34 N Albemarle St, York, PA 17403 | 2017-09-28 |
| 1275054983 | Lindsay Sentz | Nurse Anesthetist, Certified Registered | 110 Pine Grove Commons, York, PA 17403 | 2017-07-03 |
| 1649721713 | Omasiel Herenia Comrie-reinert | Nurse Practitioner | 2690 Southfield Dr Ste A, York, PA 17403 | 2016-10-24 |
| 1144675703 | Audrey C Hess | Dietitian, Registered | 35 Monument Rd Suite 202, Wellspan Maternal Fetal Medicine, York, PA 17403 | 2016-05-02 |
| 1346616505 | Joseph A Tolomeo | Psychologist | 807 S. George St, York, PA 17403 | 2015-08-11 |
| 1750798328 | Charles W. Hash Jr. | Surgery | 1400 E. Market St., York, PA 17403 | 2014-07-16 |
| 1124430764 | Kelly Michael Martin | Registered Nurse | 1001 S. Gearge St, York, PA 17403 | 2014-06-02 |
| Find all providers in zip 17403 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376153650 | Hannah Christine Kowalewski | Physician Assistant | 1765 Hillock Ln, York, PA 17403-4033 | 2020-08-03 |
| 1306461959 | Brandon Rauhauser | Physician Assistant | 1921 Worth St, York, PA 17404-5230 | 2020-06-09 |
| 1629337902 | Shannon N Moreau | Physician Assistant | 343 Us Route 1, York, ME 03909-1636 | 2012-05-08 |
| 1205117363 | Emily Macik | Physician Assistant | 1001 S George St Fl 3, York, PA 17403-3676 | 2011-09-02 |
| 1366769085 | David Arthur Hamel | Physician Assistant | 85 Brixham Rd, York, ME 03909-5342 | 2010-04-21 |
| 1649448127 | Lauralee Brooke Trump | Physician Assistant | 2532 Knobhill Rd, York, PA 17403-4796 | 2008-02-18 |
| 1699886069 | Cynthia F Helm | Physician Assistant | 1796 3rd Ave, York, PA 17403-1913 | 2006-08-31 |
| 1154393320 | Juliann Pandelidis | Physician Assistant | 80 Wyntre Brooke Dr, York, PA 17403-4535 | 2006-02-02 |
| 1740280031 | Charlotte S. Greene | Physician Assistant | 15 Hospital Dr, York, ME 03909-1011 | 2005-07-28 |
| 1306446166 | Kathryn M Fossaceca | Physician Assistant | 116 S George St, York, PA 17401-1474 | 2020-10-29 |
| Find all providers in YORK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.