Individual
MS. PAMELA SUZETTE MILAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
209 WEST STATE LINE RD., SOUTH FULTON, TN 38257
(731) 479-2112
(731) 479-2116
Mailing address
9120 NEW HOME RD, MARTIN, TN 38237
(731) 571-1395
(731) 587-3460
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0000005426
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4086343
BCBS
TN
01
—
P00168718
RAILROAD MEDICARE
TN
Enumeration date
01/25/2007
Last updated
03/04/2014
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