Provider Demographics
NPI:1235793605
Name:PRESTON, PAMELA (RRT)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:
Last Name:PRESTON
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:MS
Other - First Name:PAMELA
Other - Middle Name:
Other - Last Name:PRESTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RRT
Mailing Address - Street 1:205 LANCASTER GATE LN APT 304
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-6896
Mailing Address - Country:US
Mailing Address - Phone:804-718-5845
Mailing Address - Fax:
Practice Address - Street 1:205 LANCASTER GATE LN APT 304
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-6896
Practice Address - Country:US
Practice Address - Phone:804-718-5845
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-30
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01170088262279H0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279H0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredHome Health