Provider Demographics
NPI:1437251477
Name:DICKEY, PAMELA L (PA-C)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:L
Last Name:DICKEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:L
Other - Last Name:ZUMPFE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:8055 O ST
Mailing Address - Street 2:STE 300
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-2580
Mailing Address - Country:US
Mailing Address - Phone:402-421-0896
Mailing Address - Fax:402-421-0945
Practice Address - Street 1:1240 ARIES DR
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68512-9100
Practice Address - Country:US
Practice Address - Phone:402-420-1300
Practice Address - Fax:402-420-1326
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE884363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE13244OtherMIDLAND'S CHOICE
NE37864OtherBCBS
273702Medicare PIN
NE13244OtherMIDLAND'S CHOICE