Provider Demographics
NPI:1114514981
Name:FRALEY, PAMELA KAY
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:KAY
Last Name:FRALEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:514 N OAKLAND ST
Mailing Address - Street 2:
Mailing Address - City:URBANA
Mailing Address - State:OH
Mailing Address - Zip Code:43078-1353
Mailing Address - Country:US
Mailing Address - Phone:937-508-0228
Mailing Address - Fax:
Practice Address - Street 1:514 N OAKLAND ST
Practice Address - Street 2:
Practice Address - City:URBANA
Practice Address - State:OH
Practice Address - Zip Code:43078-1353
Practice Address - Country:US
Practice Address - Phone:937-508-0228
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-28
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide