| Doctor Name: | MS. PAMELA JEANNE NICODEMUS |
| NPI Number: | 1023093911 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS, APRN, BC |
| License Number: | RN179624L |
| Business Practice Address: | 308 Seneca St Oil City, PA - 163011378 |
| Business Phone Number: | 8146768285 |
| Business Fax Number: | 8146763382 |
| Mailing Address: | 308 Seneca St, OIL CITY |
| State: | PA |
| Postal Code: | 163011378 |
| Phone Number: | 8146768285 |
| Fax Number: | 8146763382 |
| NPI Enumeration Date: | 12/13/2005 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 364SP0808X |
| License Number: | RN179624L |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Clinical Nurse Specialist |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |