Provider Demographics
NPI:1407265820
Name:WHEELER, PAMELA (RRT,CPFT)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:WHEELER
Suffix:
Gender:F
Credentials:RRT,CPFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2845 NORTHSHORE CT
Mailing Address - Street 2:APT 101
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38016-2416
Mailing Address - Country:US
Mailing Address - Phone:573-382-3057
Mailing Address - Fax:
Practice Address - Street 1:2845 NORTHSHORE CT
Practice Address - Street 2:APT 101
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38016-2416
Practice Address - Country:US
Practice Address - Phone:573-382-3057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-11
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1013382278P1006X
TN5211227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered
No2278P1006XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedPulmonary Function Technologist