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Individual
PAMELA LYNN ADAMS LACKEY
Active
Individual
PAMELA LYNN ADAMS LACKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0550031150
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33300169
—
NH
05
—
9000586
—
VT
Enumeration date
11/15/2012
Last updated
05/01/2020
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