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Individual
MISS PAMELA JANE MOORHEAD
Active
Individual
MISS PAMELA JANE MOORHEAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703057710
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4703057710
NURSING LICENSING
MI
Enumeration date
05/06/2013
Last updated
05/06/2013
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