Provider Demographics
NPI:1760704316
Name:MCNULTY-SELL, JOELLE ELIZABETH (PA-C)
Entity Type:Individual
Prefix:MISS
First Name:JOELLE
Middle Name:ELIZABETH
Last Name:MCNULTY-SELL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
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Mailing Address - Street 1:744 W LANCASTER AVE
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19087-2523
Mailing Address - Country:US
Mailing Address - Phone:610-688-8750
Mailing Address - Fax:610-688-8751
Practice Address - Street 1:744 W LANCASTER AVE
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:PA
Practice Address - Zip Code:19087-2523
Practice Address - Country:US
Practice Address - Phone:610-688-8750
Practice Address - Fax:610-688-8751
Is Sole Proprietor?:No
Enumeration Date:2010-02-24
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMA053460363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant