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Individual
DR. PAMELA ROSE KNICKERBOCKER
Active
Individual
DR. PAMELA ROSE KNICKERBOCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
4409
OK
207Q00000X
Family Medicine Physician
A2012777
CA
207Q00000X
Family Medicine Physician
Primary
OS19486
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200182150A
—
OK
Enumeration date
02/05/2007
Last updated
02/16/2023
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