Provider Demographics
NPI:1306414123
Name:MAY, PAMELA JEAN (RN)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:JEAN
Last Name:MAY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:554 FORTY EIGHT CREEK RD
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:38485-5348
Mailing Address - Country:US
Mailing Address - Phone:850-247-2373
Mailing Address - Fax:
Practice Address - Street 1:554 FORTY EIGHT CREEK RD
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:TN
Practice Address - Zip Code:38485-5348
Practice Address - Country:US
Practice Address - Phone:850-247-2373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-17
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN154226163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse