Provider Demographics
NPI:1790229896
Name:FETTERMAN, JAMES MARK (DNP, FNP-C)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:MARK
Last Name:FETTERMAN
Suffix:
Gender:M
Credentials:DNP, FNP-C
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Mailing Address - Street 1:325 MCCLELLANDTOWN RD
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-5096
Mailing Address - Country:US
Mailing Address - Phone:724-439-3627
Mailing Address - Fax:724-439-0489
Practice Address - Street 1:325 MCCLELLANDTOWN RD
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-5096
Practice Address - Country:US
Practice Address - Phone:724-439-3627
Practice Address - Fax:724-439-0489
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-07
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PASP016793363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily