Provider Demographics
NPI:1689059610
Name:MIGLIACCIO, PAMELA LAURA (APRN, CNP)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:LAURA
Last Name:MIGLIACCIO
Suffix:
Gender:F
Credentials:APRN, CNP
Other - Prefix:
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Mailing Address - Street 1:PO BOX 721080
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73172-1080
Mailing Address - Country:US
Mailing Address - Phone:405-408-4853
Mailing Address - Fax:405-945-9151
Practice Address - Street 1:2709 SOMERSET PL
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-4008
Practice Address - Country:US
Practice Address - Phone:405-242-3554
Practice Address - Fax:405-645-5191
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-20
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK92469363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily