Provider Demographics
NPI:1164051348
Name:GARNER, PAMELA GAY
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:GAY
Last Name:GARNER
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 1:1524 GOOCH PIKE
Mailing Address - Street 2:
Mailing Address - City:PAINT LICK
Mailing Address - State:KY
Mailing Address - Zip Code:40461
Mailing Address - Country:US
Mailing Address - Phone:859-339-2429
Mailing Address - Fax:
Practice Address - Street 1:1524 GOOCH PIKE
Practice Address - Street 2:
Practice Address - City:PAINT LICK
Practice Address - State:KY
Practice Address - Zip Code:40461
Practice Address - Country:US
Practice Address - Phone:859-339-2429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-08
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider