Provider Demographics
NPI:1285182642
Name:MAY, PAMELA (DNP, MSN, FNP-BC)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:
Last Name:MAY
Suffix:
Gender:F
Credentials:DNP, MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1617 N FRONT ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17102-2414
Mailing Address - Country:US
Mailing Address - Phone:717-236-4682
Mailing Address - Fax:717-236-2423
Practice Address - Street 1:1617 N FRONT ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17102-2414
Practice Address - Country:US
Practice Address - Phone:717-236-4682
Practice Address - Fax:717-236-2423
Is Sole Proprietor?:No
Enumeration Date:2016-09-14
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP014835363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1036825150001Medicaid