Provider Demographics
NPI:1275774457
Name:PHELPS, PAMELA CAMPBELL (NP - NURSE PRACTITIO)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:CAMPBELL
Last Name:PHELPS
Suffix:
Gender:F
Credentials:NP - NURSE PRACTITIO
Other - Prefix:MS
Other - First Name:PAMELA
Other - Middle Name:SUE
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP NURSE PRACTITIONE
Mailing Address - Street 1:SPECTRUM 8695 SPECTRUM CENTER COURT
Mailing Address - Street 2:SHARP - EMPLOYEE OCCUPATIONA HEALTH
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123
Mailing Address - Country:US
Mailing Address - Phone:858-499-5259
Mailing Address - Fax:858-499-5317
Practice Address - Street 1:SPECTRUM 8695 SPECTRUM CENTER CT.
Practice Address - Street 2:SHARP EMPLOYEE OCCUPATIONAL HEALTH
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123
Practice Address - Country:US
Practice Address - Phone:858-499-5259
Practice Address - Fax:858-499-5317
Is Sole Proprietor?:No
Enumeration Date:2009-03-17
Last Update Date:2009-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4610363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner