Provider Demographics
NPI:1033863733
Name:BARRETT, PAMELLA MICHELLE (NP-C)
Entity Type:Individual
Prefix:
First Name:PAMELLA
Middle Name:MICHELLE
Last Name:BARRETT
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1902 JOHN STOCKBAUER DR STE 300
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901-3797
Mailing Address - Country:US
Mailing Address - Phone:361-864-6094
Mailing Address - Fax:
Practice Address - Street 1:1902 JOHN STOCKBAUER DR STE 300
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-3797
Practice Address - Country:US
Practice Address - Phone:361-894-6094
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-10
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1069539363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily