Provider Demographics
NPI:1417024423
Name:ROSSI, PAMELA A (CRNP)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:A
Last Name:ROSSI
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:DEININGER
Other - Last Name:ROSSI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:51 N 39TH ST
Mailing Address - Street 2:PHI-2A
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-2640
Mailing Address - Country:US
Mailing Address - Phone:215-662-9993
Mailing Address - Fax:
Practice Address - Street 1:51 N 39TH ST
Practice Address - Street 2:PHI-2A
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-2640
Practice Address - Country:US
Practice Address - Phone:215-662-9993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2015-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP007179363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily