Provider Demographics
NPI:1730812744
Name:DIMARCELLO, JOSEPHINE LYNN (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:LYNN
Last Name:DIMARCELLO
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3940 LOCUST LN
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17109-4023
Mailing Address - Country:US
Mailing Address - Phone:800-245-7277
Mailing Address - Fax:717-545-5491
Practice Address - Street 1:3400 CONCORD RD
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-9002
Practice Address - Country:US
Practice Address - Phone:717-840-7580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-07
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN599819163W00000X
PASP026028363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse