Provider Demographics
NPI:1689635658
Name:BARTELS, PAMELA K (RN)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:K
Last Name:BARTELS
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 1:3455 STUDENBERG RD
Mailing Address - Street 2:
Mailing Address - City:BOSCOBEL
Mailing Address - State:WI
Mailing Address - Zip Code:53805-9219
Mailing Address - Country:US
Mailing Address - Phone:608-537-2163
Mailing Address - Fax:608-537-3535
Practice Address - Street 1:3455 STUDENBERG RD
Practice Address - Street 2:
Practice Address - City:BOSCOBEL
Practice Address - State:WI
Practice Address - Zip Code:53805-9219
Practice Address - Country:US
Practice Address - Phone:608-537-2163
Practice Address - Fax:608-537-3535
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI124075163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38264400Medicaid