Nicole O'Shurak

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

SP015669 Issued in PA

Practice address

3265 County Line Rd
Chalfont, PA 18914-3712

Phone

(215) 996-9839

NPI assigned

Nov 17, 2015

Last updated

Jul 6, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Nicole Urban Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1447718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625529600000",
    "number": "1225402035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3265 COUNTY LINE RD",
            "city": "CHALFONT",
            "state": "PA",
            "postal_code": "189143712",
            "telephone_number": "215-996-9839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3265 COUNTY LINE RD",
            "city": "CHALFONT",
            "state": "PA",
            "postal_code": "189143712",
            "telephone_number": "215-996-9839"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2434 Catasauqua Rd",
            "address_purpose": "LOCATION",
            "city": "Bethlehem",
            "state": "PA",
            "postal_code": "180181008",
            "country_code": "US",
            "telephone_number": "610-868-5122",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'SHURAK",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-17",
        "last_updated": "2021-07-06",
        "certification_date": "2021-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP015669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "URBAN",
            "credential": "CRNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Marina H. Opdam, PT
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• Family Nurse Practitioner in Chalfont, PA
• Providers in Chalfont, PA by specialty
• Family Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.