Provider Demographics
NPI:1164921920
Name:ROBORDS, PAMELA SUE (LPN)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:SUE
Last Name:ROBORDS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:SUE
Other - Last Name:WILLIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:3604 COUNTY ROUTE 70A
Mailing Address - Street 2:
Mailing Address - City:HORNELL
Mailing Address - State:NY
Mailing Address - Zip Code:14843-9222
Mailing Address - Country:US
Mailing Address - Phone:607-329-8776
Mailing Address - Fax:
Practice Address - Street 1:3604 COUNTY ROUTE 70A
Practice Address - Street 2:
Practice Address - City:HORNELL
Practice Address - State:NY
Practice Address - Zip Code:14843-9222
Practice Address - Country:US
Practice Address - Phone:607-329-8776
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-07
Last Update Date:2018-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY190399164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse