Provider Demographics
NPI:1609538115
Name:SCHLEGEL, NICOLE ANN (PA)
Entity type:Individual
Prefix:MISS
First Name:NICOLE
Middle Name:ANN
Last Name:SCHLEGEL
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 BRADFORD ROAD
Mailing Address - Street 2:STE 410
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-8489
Mailing Address - Country:US
Mailing Address - Phone:724-965-8946
Mailing Address - Fax:724-965-8953
Practice Address - Street 1:100 BRADFORD ROAD
Practice Address - Street 2:STE 410
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-8489
Practice Address - Country:US
Practice Address - Phone:724-965-8946
Practice Address - Fax:724-965-8953
Is Sole Proprietor?:No
Enumeration Date:2021-10-12
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA063193363AM0700X
363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical