Provider Demographics
NPI:1548597230
Name:KAMAN, PAMELA LOUISE (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:LOUISE
Last Name:KAMAN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MRS
Other - First Name:PAMELA
Other - Middle Name:LOUISE
Other - Last Name:WHITEAMIRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:799 LEXINTON AVE
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44907-1906
Mailing Address - Country:US
Mailing Address - Phone:419-756-5133
Mailing Address - Fax:
Practice Address - Street 1:799 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44907-1906
Practice Address - Country:US
Practice Address - Phone:419-756-5133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-17
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CRNA.0020273367500000X
OHRN260479163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1548597230Medicaid
WA8940078Medicare PIN