Diane R. McNickle, CRNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

TP005852C Issued in PA

Practice address

1425 Horsham Rd
North Wales, PA 19454-1320

Phone

(215) 371-6310

NPI assigned

Aug 25, 2006

Last updated

Jul 8, 2014By 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

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": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404777600000",
    "number": "1437267127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 TOWER RD",
            "city": "SELLERSVILLE",
            "state": "PA",
            "postal_code": "189603128",
            "telephone_number": "215-453-7613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 HORSHAM RD",
            "city": "NORTH WALES",
            "state": "PA",
            "postal_code": "194541320",
            "telephone_number": "215-371-6310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNICKLE",
        "first_name": "DIANE",
        "middle_name": "R.",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2014-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "TP005852C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Consultants
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• Merck

• Nurse Practitioner in North Wales, PA
• Providers in North Wales, PA by specialty
• Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2014; 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.