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Individual

MS. PAMELA LARSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
PEDIATRIC OUTPATIENT CENTER, 600 MOYE BLVD, GREENVILLE, NC 27858
(252) 744-2335
(252) 744-3811
Mailing address
PO BOX 751069, CHARLOTTE, NC 28275-1069
(252) 744-3253
(252) 744-3194

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
200754
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
500003550
RAILROAD MEDICARE
NC
05
7000225
NC
Enumeration date
01/05/2006
Last updated
03/25/2009
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