Provider Demographics
NPI:1013744853
Name:PUCEL, AMBERLYN
Entity type:Individual
Prefix:
First Name:AMBERLYN
Middle Name:
Last Name:PUCEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AMBERLYN
Other - Middle Name:
Other - Last Name:SUCEVICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:117 CEMETERY RD
Mailing Address - Street 2:
Mailing Address - City:VANDERBILT
Mailing Address - State:PA
Mailing Address - Zip Code:15486-1165
Mailing Address - Country:US
Mailing Address - Phone:412-841-8727
Mailing Address - Fax:
Practice Address - Street 1:565 COAL VALLEY RD
Practice Address - Street 2:
Practice Address - City:JEFFERSON HILLS
Practice Address - State:PA
Practice Address - Zip Code:15025-3703
Practice Address - Country:US
Practice Address - Phone:412-469-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-16
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP030685363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care