Provider Demographics
NPI:1588678510
Name:HIRST, PAMELA KAY (NP)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:KAY
Last Name:HIRST
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:318 SHIRLEY LOOP
Mailing Address - Street 2:
Mailing Address - City:WHITWELL
Mailing Address - State:TN
Mailing Address - Zip Code:37397-5938
Mailing Address - Country:US
Mailing Address - Phone:423-658-9938
Mailing Address - Fax:423-837-5412
Practice Address - Street 1:7333 LEE HWY STE C
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-8001
Practice Address - Country:US
Practice Address - Phone:423-499-5655
Practice Address - Fax:423-499-8085
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6157363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNS56346Medicare UPIN