Provider Demographics
NPI:1073929584
Name:BARNETT, PAMELA (RN)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:BARNETT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:
Other - Last Name:BARNETT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:R,N
Mailing Address - Street 1:43817 59TH ST W
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93536-7151
Mailing Address - Country:US
Mailing Address - Phone:661-579-0433
Mailing Address - Fax:
Practice Address - Street 1:43817 59TH ST W
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93536-7151
Practice Address - Country:US
Practice Address - Phone:661-579-0433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-03
Last Update Date:2014-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA797338163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA797338OtherREGISTERED NURSE