Provider Demographics
NPI:1366687287
Name:DWYER, PAMELA DAWN (DNP, CRNP)
Entity type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:DAWN
Last Name:DWYER
Suffix:
Gender:F
Credentials:DNP, CRNP
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:DAWN
Other - Last Name:MCELVAIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:WELSH
Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:570-271-6578
Practice Address - Street 1:42M MAIN ST
Practice Address - Street 2:
Practice Address - City:PITTSTON
Practice Address - State:PA
Practice Address - Zip Code:18640-3103
Practice Address - Country:US
Practice Address - Phone:570-602-5610
Practice Address - Fax:570-602-5611
Is Sole Proprietor?:No
Enumeration Date:2008-12-05
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP009942363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily