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Individual

MS. PAMELA HELEN KING

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PMHNP, CNS BC

Contact information

Practice address
1387 FAIRPORT RD, BUILDING 600 SUITE 660, FAIRPORT, NY 14450-2003
(585) 388-8020
(585) 388-8023
Mailing address
5757 DALTON DR, FARMINGTON, NY 14425-9328
(585) 398-3575
(585) 388-8023

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F400449-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
400449
NY
Enumeration date
07/10/2006
Last updated
07/08/2007
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