Individual
PAMELA J CAROTHERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1720 S BURLINGTON DR, MUNCIE, IN 47302-2771
(765) 216-7620
(765) 216-7681
Mailing address
1720 S BURLINGTON DR, MUNCIE, IN 47302-2771
(765) 216-7620
(765) 216-7681
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71000313A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200289020
—
IN
01
—
P00874031
RR MEDICARE
IN
Enumeration date
01/10/2007
Last updated
04/11/2013
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