Nicole Renae Bane
Nicole Renae Bane is an Internal Medicine in Jbsa Lackland, Texas. Graduated from Lake Erie College of Osteopathic Medicine, Erie in 2014, 12 years ago. Practices with St Clair Professional Services Inc, a 74-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Pennsylvania.
- Years since qualifying
- 12
- Trained at
- Lake Erie College of Osteopathic Medicine, Erie
- Licensed in
- PA
- In the registry since
- 2014
- Specialties on file
- 2
Practice location Address checks out
1100 Wilford Hall Loop Bldg 4554Jbsa Lackland, TX 78236-5638
Phone: (724) 494-0341
Fax: (210) 292-7868
Show map & directions
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Additional practice locations (1)
- 1400 Locust St, Pittsburgh, PA 15219-5114 — (412) 232-5533
Specialties & licences
| Internal Medicine Physician (primary) | Taxonomy 207R00000X · Licence OS018569 (PA) |
|---|---|
| Internal Medicine Physician | Taxonomy 207R00000X · Licence OT015982 (PA) |
Record details
| NPI number | 1629480462 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | No |
| NPI enumerated | May 28, 2014 |
| Last updated in NPPES | February 23, 2021 |
| Certification date | February 23, 2021 |
| Mailing address | 1100 Wilford Hall Loop Bldg 4554, Jbsa Lackland, TX 78236-5638 |
Medicare enrollment
| Medicare specialty | INTERNAL MEDICINE |
|---|---|
| Medical school | LAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE, ERIE |
| Graduated | 2014 (12 years in practice) |
| Group practice | St Clair Professional Services Inc — 74 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
Other providers in Jbsa Lackland
-
Aneesh Atul Bapodra
1100 Wilford Hall Loop, Jbsa Lackland, TX 78236 · (210) 292-7805
-
Dr. Molly Kathleen Boyer, MD
1100 Wilford Hall Loop Bldg 4554 Attn: 59 Mdw/sghc, Jbsa Lackland, TX 78236 · (210) 292-6225
-
Dominic Bracero, MD
1100 Wilford Hall Loop, Jbsa Lackland, TX 78236-5638 · (210) 292-7805
-
Miles Campbell, DO
1100 Wilford Hall Loop Bldg 4554, Jbsa Lackland, TX 78236 · (210) 292-7862