Provider Demographics
NPI:1609460757
Name:FIELDS, PAMELA DAWN (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:DAWN
Last Name:FIELDS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11047 CASTLEMAIN CIR E
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-2894
Mailing Address - Country:US
Mailing Address - Phone:904-860-1800
Mailing Address - Fax:904-956-3262
Practice Address - Street 1:4500 SAN PABLO ROAD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32224
Practice Address - Country:US
Practice Address - Phone:904-956-3272
Practice Address - Fax:904-956-3262
Is Sole Proprietor?:No
Enumeration Date:2021-03-01
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11022850363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner