Provider Demographics
NPI:1033137336
Name:PARKS OZALUK, PAMELA JEAN (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:JEAN
Last Name:PARKS OZALUK
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1303 3RD STREET CIR E
Mailing Address - Street 2:
Mailing Address - City:PALMETTO
Mailing Address - State:FL
Mailing Address - Zip Code:34221-4242
Mailing Address - Country:US
Mailing Address - Phone:970-281-2292
Mailing Address - Fax:
Practice Address - Street 1:3301 HARDEN STREET EXT 5 MEDICAL PARK
Practice Address - Street 2:PLAMETTO HEALTH RICLAND
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203
Practice Address - Country:US
Practice Address - Phone:803-296-2548
Practice Address - Fax:803-296-2525
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2931367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCAN1517Medicaid
SCQ343125769Medicare PIN
SCAN1517Medicaid