Individual
MRS. PAMELA ANN NULL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP, NP-C
Contact information
Practice address
635 MAPLE AVENUE, DUBOIS, PA 15801-2376
(814) 375-6379
(814) 375-9320
Mailing address
621 S MAIN ST, DU BOIS, PA 15801-1413
(814) 299-7520
(814) 375-7798
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
SP015397
PA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
SP029112
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SP029112
PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER
PA
Enumeration date
12/21/2015
Last updated
01/19/2024
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