Provider Demographics
NPI:1649694894
Name:MEST, CAROL GULLO (CRNP)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:GULLO
Last Name:MEST
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1930 BLACK RIVER RD
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015-8919
Mailing Address - Country:US
Mailing Address - Phone:610-867-9919
Mailing Address - Fax:610-282-2091
Practice Address - Street 1:7248 TILGHMAN ST
Practice Address - Street 2:SUITE 160
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18106-9355
Practice Address - Country:US
Practice Address - Phone:610-336-8000
Practice Address - Fax:610-336-6082
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-08
Last Update Date:2014-02-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAUP000891C2363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health