Provider Demographics
NPI:1710211644
Name:ARMSTRONG, PAMELA F (NP)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:F
Last Name:ARMSTRONG
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 PRAIRIE LN
Mailing Address - Street 2:
Mailing Address - City:CISSNA PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60924-9710
Mailing Address - Country:US
Mailing Address - Phone:815-457-2000
Mailing Address - Fax:815-457-2015
Practice Address - Street 1:510 PRAIRIE LN
Practice Address - Street 2:
Practice Address - City:CISSNA PARK
Practice Address - State:IL
Practice Address - Zip Code:60924-9710
Practice Address - Country:US
Practice Address - Phone:815-457-2000
Practice Address - Fax:815-457-2015
Is Sole Proprietor?:No
Enumeration Date:2009-09-24
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209007782363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL370647938OtherFEDERAL TAX ID