Provider Demographics
NPI:1033193651
Name:JONES, PAMELA PITT (FNP C)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:PITT
Last Name:JONES
Suffix:
Gender:F
Credentials:FNP C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:578 STATE ROUTE 244
Mailing Address - Street 2:
Mailing Address - City:ALFRED STATION
Mailing Address - State:NY
Mailing Address - Zip Code:14803
Mailing Address - Country:US
Mailing Address - Phone:607-587-9389
Mailing Address - Fax:607-587-9389
Practice Address - Street 1:578 STATE ROUTE 244
Practice Address - Street 2:
Practice Address - City:ALFRED STATION
Practice Address - State:NY
Practice Address - Zip Code:14803
Practice Address - Country:US
Practice Address - Phone:607-587-9389
Practice Address - Fax:607-587-9389
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF332476-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02603450Medicaid
NY500018692OtherRAILROAD MEDICARE
NY500018692OtherRAILROAD MEDICARE
P03224Medicare UPIN