Provider Demographics
NPI:1225138969
Name:MCNISH, PAMELA S (PHD)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:S
Last Name:MCNISH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2908 TAZEWELL PIKE
Mailing Address - Street 2:SUITE N
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37918-1878
Mailing Address - Country:US
Mailing Address - Phone:865-686-1646
Mailing Address - Fax:865-522-6394
Practice Address - Street 1:2908 TAZEWELL PIKE
Practice Address - Street 2:SUITE N
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37918-1878
Practice Address - Country:US
Practice Address - Phone:865-686-1646
Practice Address - Fax:865-522-6394
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP0000001988103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical