Provider Demographics
NPI:1568622488
Name:GARZA, PAMELA IRENE (RN)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:IRENE
Last Name:GARZA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1127 ALDERSON AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-4200
Mailing Address - Country:US
Mailing Address - Phone:406-245-7318
Mailing Address - Fax:406-248-3043
Practice Address - Street 1:1127 ALDERSON AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-4200
Practice Address - Country:US
Practice Address - Phone:406-245-7318
Practice Address - Fax:406-248-3043
Is Sole Proprietor?:No
Enumeration Date:2008-06-13
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT26845163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0730288Medicaid