Provider Demographics
NPI:1710182159
Name:FEAGANES, PAMELA SUSAN (RN, CCM)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:SUSAN
Last Name:FEAGANES
Suffix:
Gender:F
Credentials:RN, CCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1631 CORINTHIAN DR
Mailing Address - Street 2:# 2025
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-7423
Mailing Address - Country:US
Mailing Address - Phone:859-384-9215
Mailing Address - Fax:859-384-9218
Practice Address - Street 1:5500 GLENDON CT
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-3246
Practice Address - Country:US
Practice Address - Phone:877-641-2010
Practice Address - Fax:614-760-3597
Is Sole Proprietor?:No
Enumeration Date:2007-06-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH304467163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management