Provider Demographics
NPI:1598137903
Name:SCHANK, PAMELA (RN)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:SCHANK
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 1:9943 LANCASTER DR
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48111-1693
Mailing Address - Country:US
Mailing Address - Phone:734-272-3420
Mailing Address - Fax:
Practice Address - Street 1:9943 LANCASTER DR
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48111-1693
Practice Address - Country:US
Practice Address - Phone:734-272-3420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-24
Last Update Date:2015-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704281147163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse