Provider Demographics
NPI:1508555855
Name:VOGEL, PAMELA L (LPN)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:L
Last Name:VOGEL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MRS
Other - First Name:PAMELA
Other - Middle Name:L
Other - Last Name:RUDD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:1481 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:KY
Mailing Address - Zip Code:40361-1270
Mailing Address - Country:US
Mailing Address - Phone:859-987-2166
Mailing Address - Fax:
Practice Address - Street 1:1481 MAIN ST
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:KY
Practice Address - Zip Code:40361-1270
Practice Address - Country:US
Practice Address - Phone:859-987-2166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-03
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2050490164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse