# PAMELA D MACKAY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1124562012
- **Gender:** F
- **Credential:** FNP-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | AP132740 | TX | Yes |

## Other

- **Enumeration date:** 12/12/2016
- **Last updated:** 02/16/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 369920901 | — | TX |
| 05 | — | 369920902 | — | TX |
| 01 | — | 552857YMAF | MEDICARE | TX |
| 01 | — | 75-1976930-005 | TRICARE | TX |
| 01 | — | 752616977020 | TRICARE | TX |
| 01 | — | 8462MB | BCBS | TX |
| 01 | — | 8HL389 | BCBS | TX |
| 01 | — | P01787234 | RAIL ROAD MEDICARE | TX |
| 01 | — | P01938229 | MEDICARE RAIL ROAD | TX |