Provider Demographics
NPI:1003049339
Name:MUSSER, PAMELA ANN (LPN)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:ANN
Last Name:MUSSER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MRS
Other - First Name:PAMELA
Other - Middle Name:ANN
Other - Last Name:CLUXTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:412 S. EAST ST.
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OH
Mailing Address - Zip Code:45133-1408
Mailing Address - Country:US
Mailing Address - Phone:937-402-4365
Mailing Address - Fax:
Practice Address - Street 1:412 S. EAST ST.
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OH
Practice Address - Zip Code:45133-1408
Practice Address - Country:US
Practice Address - Phone:937-402-4365
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-03
Last Update Date:2009-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN066253164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse