Individual
PAMELA LYNNE DISNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
217 NEWMAN ST, ROSCOMMON, MI 48653-7603
(989) 390-6580
Mailing address
217 NEWMAN ST, ROSCOMMON, MI 48653-7603
(989) 390-6580
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703109354
MI
Other
Enumeration date
03/06/2015
Last updated
03/06/2015
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