Provider Demographics
NPI:1073109260
Name:OSHELL, PAMELA L (STNA)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:L
Last Name:OSHELL
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2026 BROOKLINE AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45420-2443
Mailing Address - Country:US
Mailing Address - Phone:937-304-6384
Mailing Address - Fax:
Practice Address - Street 1:7055 PARAGON RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45459-3143
Practice Address - Country:US
Practice Address - Phone:937-304-6384
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-12
Last Update Date:2020-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5714712374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide