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NPI Code Detail

MEDICARE: PAMELA MJ VAN DE CAPPELLE APRN-BC

MEDICARE: PAMELA MJ VAN DE CAPPELLE APRN-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner11014779FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1275720617
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAMELA MJ VAN DE CAPPELLE APRN-BC
Provider Business Mailing Address
First Line : 14100 58TH ST N
Second Line :
City : CLEARWATER
State : FL
Zip : 33760-9900
Country : US
Telephone Number : 727-824-8181
Fax Number :
Provider Business Practice Location Address
First Line : 247 S HUEY AVE
Second Line :
City : TARPON SPRINGS
State : FL
Zip : 34689-4205
Country : US
Telephone Number : 727-824-8181
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/01/2007
Last Update Date : 09/25/2024

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