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Individual
PAMELA SUZANNE JACKS PORTNOY
Active
Individual
PAMELA SUZANNE JACKS PORTNOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, FNP, DNP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041-570423
IL
163W00000X
Registered Nurse
766010
CA
363L00000X
Nurse Practitioner
277-003899
IL
363LF0000X
Family Nurse Practitioner
Primary
21608
CA
363LF0000X
Family Nurse Practitioner
377-003662
IL
Other
Enumeration date
02/07/2012
Last updated
10/30/2025
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