Provider Demographics
NPI:1255654331
Name:MOUNCE, PAMELA MARIE (APN, MSN)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:MARIE
Last Name:MOUNCE
Suffix:
Gender:F
Credentials:APN, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:16412 MAJESTIC LN
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72764-6745
Mailing Address - Country:US
Mailing Address - Phone:479-200-9295
Mailing Address - Fax:479-966-4713
Practice Address - Street 1:16412 MAJESTIC LN
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72764-6745
Practice Address - Country:US
Practice Address - Phone:479-200-9295
Practice Address - Fax:479-966-4713
Is Sole Proprietor?:No
Enumeration Date:2010-03-03
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA03330363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR182748758Medicaid