Provider Demographics
NPI:1356846471
Name:HUMPHREY, PAMELA (APRN,FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:
Last Name:HUMPHREY
Suffix:
Gender:F
Credentials:APRN,FNP-BC
Other - Prefix:MRS
Other - First Name:PAMELA
Other - Middle Name:DENISE
Other - Last Name:HUMPHERY-KAMATEH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1121 TWIN CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37217-4068
Mailing Address - Country:US
Mailing Address - Phone:615-779-8410
Mailing Address - Fax:
Practice Address - Street 1:1310 24TH AVE S
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-2637
Practice Address - Country:US
Practice Address - Phone:615-873-8484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-29
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000023482363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily