Provider Demographics
NPI:1225013667
Name:NELSON, PAMELA A (AUD)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:A
Last Name:NELSON
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:A
Other - Last Name:KLINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5330 N OAK TRFY
Mailing Address - Street 2:SUITE 201
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64118-4699
Mailing Address - Country:US
Mailing Address - Phone:816-454-0666
Mailing Address - Fax:816-454-1694
Practice Address - Street 1:5330 N OAK TRFY
Practice Address - Street 2:SUITE 201
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64118-4699
Practice Address - Country:US
Practice Address - Phone:816-454-0666
Practice Address - Fax:816-454-1694
Is Sole Proprietor?:No
Enumeration Date:2005-12-08
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO02073231H00000X
KS580231H00000X
MO001022237700000X
KS0153237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO640002924OtherRAILROAD MEDICARE
KSK872974OtherMEDICARE-KS
KSK872974OtherMEDICARE-KS
R89404Medicare UPIN
MO640002924OtherRAILROAD MEDICARE
R89404Medicare UPIN