Provider Demographics
NPI:1407466899
Name:ENGELKE, PAMELA ANN (RN)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:ANN
Last Name:ENGELKE
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 1:240 NICE LN APT 117
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-2652
Mailing Address - Country:US
Mailing Address - Phone:562-420-2465
Mailing Address - Fax:
Practice Address - Street 1:240 NICE LN APT 117
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-2652
Practice Address - Country:US
Practice Address - Phone:562-420-2465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-31
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA248243163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management