Individual
PAMELA DOLOSZYCKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
1001 MAIN ST, SUITE 200, PEORIA, IL 61606-1907
(309) 672-5682
(309) 672-3147
Mailing address
1001 MAIN ST, SUITE 200, PEORIA, IL 61606-1907
(309) 672-5682
(309) 672-3147
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209003010
IL
363LP0200X
Pediatric Nurse Practitioner
Primary
209-003010
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209-003010
APN
IL
05
—
209003010
—
IL
Enumeration date
11/13/2006
Last updated
01/21/2009
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