Provider Demographics
NPI:1518217124
Name:KEATON-CARTER, PAMELA RENEE
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:RENEE
Last Name:KEATON-CARTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4390 PROSPECTOR LN
Mailing Address - Street 2:
Mailing Address - City:PAHRUMP
Mailing Address - State:NV
Mailing Address - Zip Code:89048-4389
Mailing Address - Country:US
Mailing Address - Phone:775-443-6111
Mailing Address - Fax:
Practice Address - Street 1:4390 PROSPECTOR LN
Practice Address - Street 2:
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89048-4389
Practice Address - Country:US
Practice Address - Phone:775-443-6111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-12
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner