Individual
PAMELA JANE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NNP
Contact information
Practice address
4420 LAKE BOONE TRL, RALEIGH, NC 27607-7505
(919) 784-3100
Mailing address
4420 LAKE BOONE TRL, RALEIGH, NC 27607-7505
(919) 784-3100
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
5004835
NC
363LN0005X
Critical Care Neonatal Nurse Practitioner
5004835
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1881908846
—
NC
Enumeration date
08/02/2010
Last updated
02/23/2024
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