Provider Demographics
NPI:1356643381
Name:CARMICHAEL, PAMELA ANN (BSN)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:ANN
Last Name:CARMICHAEL
Suffix:
Gender:F
Credentials:BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 ANNAQUATUCKET RD
Mailing Address - Street 2:
Mailing Address - City:NORTH KINGSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02852-6127
Mailing Address - Country:US
Mailing Address - Phone:401-294-9332
Mailing Address - Fax:
Practice Address - Street 1:155 ANNAQUATUCKET RD
Practice Address - Street 2:
Practice Address - City:NORTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02852-6127
Practice Address - Country:US
Practice Address - Phone:401-294-9332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-24
Last Update Date:2010-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001136301163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse