Provider Demographics
NPI:1073693768
Name:CONRAD, PAMELA KAY (RN)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:KAY
Last Name:CONRAD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 EDGEHILL CIR
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:OH
Mailing Address - Zip Code:43138-9296
Mailing Address - Country:US
Mailing Address - Phone:740-216-0234
Mailing Address - Fax:
Practice Address - Street 1:525 EDGEHILL CIR
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:OH
Practice Address - Zip Code:43138-9296
Practice Address - Country:US
Practice Address - Phone:740-216-0234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2009-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN271272163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse