Provider Demographics
NPI:1225469901
Name:VERMEULEN, CHARLOTTE (CRNP)
Entity Type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:
Last Name:VERMEULEN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2006 COAL HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:APOLLO
Mailing Address - State:PA
Mailing Address - Zip Code:15613-9024
Mailing Address - Country:US
Mailing Address - Phone:724-727-3614
Mailing Address - Fax:
Practice Address - Street 1:943 FOURTH AVE
Practice Address - Street 2:
Practice Address - City:NEW KENSINGTON
Practice Address - State:PA
Practice Address - Zip Code:15068-6409
Practice Address - Country:US
Practice Address - Phone:724-335-3334
Practice Address - Fax:724-335-2283
Is Sole Proprietor?:No
Enumeration Date:2013-12-06
Last Update Date:2014-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASPO13456363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily