Individual
PAMELA JUNE GARDNER-DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNS
Contact information
Practice address
4825 S LABURNUM AVE, RICHMOND, VA 23231-2713
(804) 222-2607
(804) 236-9118
Mailing address
10299 WOODMAN RD, GLEN ALLEN, VA 23060-4419
(804) 727-8500
(804) 727-8580
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
0001096960
VA
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
0015000486
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
162856
ANTHEM
VA
Enumeration date
02/16/2007
Last updated
09/26/2008
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