Jami Alyssa Rubin Pavlak, NP
Nurse Practitioner, Psych/Mental Health in State College, PA. Individual provider (NPI-1).
NPI number1265770010
StatusActive
Last updated in NPPESFeb 10, 2022
Details
- NPI
- 1265770010
- Entity type
- Individual (NPI-1)
- Name
- Jami Alyssa Rubin Pavlak
- Credential
- NP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 29, 2013
- Certification date
- Feb 10, 2022
- Last updated
- Feb 10, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | SP025348 | PA | Yes |
| 363LP0200X | Nurse Practitioner, Pediatrics | 4704294965 | MI | |
| 363LP0200X | Nurse Practitioner, Pediatrics | SP018828 | PA |
Other names
- Jami Alyssa Rubin (Former Name)
Practice location
320 Rolling Ridge Dr Ste 100State College, PA 16801-7641
Phone 814-867-0670 · Fax 814-867-7616
Mailing address
320 Rolling Ridge Dr Ste 100State College, PA 16801-7641
Phone 814-867-0670 · Fax 814-867-7616
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