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Individual
MRS. PAMELA FAY JOHNSON
Active
Individual
MRS. PAMELA FAY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
22696
WV
164W00000X
Licensed Practical Nurse
Primary
PN091552
OH
164W00000X
Licensed Practical Nurse
PN275454
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2189224
IP NUMBER
OH
01
—
22696
WV NURSING LICENSE
WV
01
—
PN091552
NURSING LICENSE
OH
01
—
PN275454
PA NURSING LICENSE
PA
Enumeration date
04/02/2007
Last updated
07/08/2007
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