Provider Demographics
NPI:1487846796
Name:WEBB, PAMELA KAYE (LPN/ IV)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:KAYE
Last Name:WEBB
Suffix:
Gender:F
Credentials:LPN/ IV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3740 OLIVESBURG RD
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44903-9005
Mailing Address - Country:US
Mailing Address - Phone:419-522-3539
Mailing Address - Fax:
Practice Address - Street 1:3740 OLIVESBURG RD
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44903-9005
Practice Address - Country:US
Practice Address - Phone:419-522-3539
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-10
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN091006164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse