Provider Demographics
NPI:1356653919
Name:KLASSEN, PAMELA KAY MARIE (RN, FNP-BC, ARNP,)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:KAY MARIE
Last Name:KLASSEN
Suffix:
Gender:F
Credentials:RN, FNP-BC, ARNP,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P. O. BOX 465
Mailing Address - Street 2:
Mailing Address - City:KALEDEN
Mailing Address - State:B.C.
Mailing Address - Zip Code:V0H 1K0
Mailing Address - Country:CA
Mailing Address - Phone:250-497-8012
Mailing Address - Fax:
Practice Address - Street 1:324 W OCEAN BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:LOS FRESNOS
Practice Address - State:TX
Practice Address - Zip Code:78566-3667
Practice Address - Country:US
Practice Address - Phone:956-233-2163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-11
Last Update Date:2012-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX664234363LF0000X, 364SM0705X
WAAP60288007363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No364SM0705XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistMedical-Surgical