Individual
MRS. PAMELA DENISE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
4100 N WICKHAM RD UNIT 107A-334, MELBOURNE, FL 32935-2485
(757) 644-9980
Mailing address
4100 N WICKHAM RD UNIT 107A-334, MELBOURNE, FL 32935-2485
(757) 644-9980
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
11032874
FL
Other
Enumeration date
05/17/2024
Last updated
05/17/2024
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