Healthcare Provider Details

I. General information

NPI: 1225523756
Provider Name (Legal Business Name): JOSHUA S DULL CRNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2018
Last Update Date: 05/10/2024
Certification Date: 05/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18117 MAUGANS AVE SUITE 201
HAGERSTOWN MD
21740
US

IV. Provider business mailing address

8664 ANTRIM CHURCH RD
GREENCASTLE PA
17225-9541
US

V. Phone/Fax

Practice location:
  • Phone: 240-563-9247
  • Fax:
Mailing address:
  • Phone: 717-860-9421
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN592263
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: