Individual
PAMELA JENNINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3601 W 13 MILE RD, FSC, ROYAL OAK, MI 48073-6712
(248) 423-2454
(248) 423-2454
Mailing address
26901 BEAUMONT BLVD, SOUTHFIELD, MI 48033-3849
(947) 577-3313
(947) 577-3302
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
4704140788
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4823419
—
MI
01
—
500F318190
BCBSM
MI
Enumeration date
07/31/2006
Last updated
01/19/2021
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