Individual provider Active NPI

Pamela Jeanne Nicodemus, MS, APRN, BC

  • Psychiatric/Mental Health Clinical Nurse Specialist
  • Oil City, PA
National Provider Identifier
1023093911
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X
License
RN179624L Issued in PA
Practice address
308 Seneca St
Oil City, PA 16301-1378
Phone
(814) 676-8285
Fax
(814) 676-3382
NPI assigned
Dec 13, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Clinical Nurse Specialist 364SP0808X RN179624L PA Primary

Addresses

Primary practice location

308 Seneca St
Oil City, PA 16301-1378

Mailing address

308 Seneca St
Oil City, PA 16301-1378
Phone (814) 676-8285

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050926000880 PA Practitioner - Certified Clinical Nurse Specialist (CNS) 7911931290 Practice locations: Oil City, PA

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

240 Elm St
Oil City, PA 16301-3254
Phone (814) 673-1026

302 Seneca St
Oil City, PA 16301-1335

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist, Master of Science

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1023093911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 SENECA ST",
            "city": "OIL CITY",
            "state": "PA",
            "postal_code": "163011378",
            "telephone_number": "814-676-8285",
            "fax_number": "814-676-3382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 SENECA ST",
            "city": "OIL CITY",
            "state": "PA",
            "postal_code": "163011378",
            "telephone_number": "814-676-8285",
            "fax_number": "814-676-3382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICODEMUS",
        "first_name": "PAMELA",
        "middle_name": "JEANNE",
        "name_prefix": "Ms.",
        "credential": "MS, APRN, BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-13",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "PA",
            "license": "RN179624L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oil City, PA

Sources for this page

Verify at the official NPI Registry.