Provider Demographics
NPI:1629124730
Name:TETLOW, PAMELA RUTHANN (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:RUTHANN
Last Name:TETLOW
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 1:2071 N POINTE ALEXIS DR
Mailing Address - Street 2:
Mailing Address - City:TARPON SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34689-2063
Mailing Address - Country:US
Mailing Address - Phone:727-942-8461
Mailing Address - Fax:727-942-8637
Practice Address - Street 1:7402 N 56TH ST
Practice Address - Street 2:906
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33617-7733
Practice Address - Country:US
Practice Address - Phone:727-536-4119
Practice Address - Fax:727-538-5529
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9197916163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics