Provider Demographics
NPI:1033318399
Name:HARRISON, PAMELA F (CNA)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:F
Last Name:HARRISON
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:MRS
Other - First Name:PAMELA
Other - Middle Name:F
Other - Last Name:HARRISON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CNA
Mailing Address - Street 1:185 OLD DUTCH VALLEY RD
Mailing Address - Street 2:CLINTON
Mailing Address - City:CLINTON
Mailing Address - State:TN
Mailing Address - Zip Code:37716-5510
Mailing Address - Country:US
Mailing Address - Phone:865-426-8282
Mailing Address - Fax:
Practice Address - Street 1:710 N MAIN ST
Practice Address - Street 2:SUITE D
Practice Address - City:CLINTON
Practice Address - State:TN
Practice Address - Zip Code:37716-3143
Practice Address - Country:US
Practice Address - Phone:865-425-8800
Practice Address - Fax:865-457-4850
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-16
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN99806376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide