Provider Demographics
NPI:1164946307
Name:ADAMS, PAMELA (MS, CNS, LDN)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:
Last Name:ADAMS
Suffix:
Gender:F
Credentials:MS, CNS, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1976 SCOTTS CROSSING WAY APT 301
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-8227
Mailing Address - Country:US
Mailing Address - Phone:443-333-9332
Mailing Address - Fax:
Practice Address - Street 1:1834 GEORGE AVE
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-4103
Practice Address - Country:US
Practice Address - Phone:443-333-9332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-31
Last Update Date:2017-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDX4249133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Single Specialty