Provider Demographics
NPI:1942194576
Name:YURCABA, NICHOLAS DEVON
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:DEVON
Last Name:YURCABA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:NICHOLAS
Other - Middle Name:DEVON
Other - Last Name:COOKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:85 TOPAZ DR
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17202-8660
Mailing Address - Country:US
Mailing Address - Phone:719-680-8313
Mailing Address - Fax:
Practice Address - Street 1:655 W LOMBARD ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1512
Practice Address - Country:US
Practice Address - Phone:410-706-0501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-06
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program