Provider Demographics
NPI:1598800237
Name:BARIOLA, PAMELA ANN (FNP-BC)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:ANN
Last Name:BARIOLA
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8071 WINCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38125-8206
Mailing Address - Country:US
Mailing Address - Phone:901-756-6056
Mailing Address - Fax:901-624-0702
Practice Address - Street 1:8071 WINCHESTER RD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38125-8206
Practice Address - Country:US
Practice Address - Phone:901-756-6056
Practice Address - Fax:901-624-0702
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2017-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN21245363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS05835083Medicaid
TN6085158OtherBCBS
TN6085214OtherBCBS
TN6085206OtherBCBS
TN6085158OtherBCBS
MS05835083Medicaid