Provider Demographics
NPI:1760036735
Name:MASLEN, PAMELA RYAN (FNP)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:RYAN
Last Name:MASLEN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3924 MINNESOTA AVE NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-2661
Mailing Address - Country:US
Mailing Address - Phone:202-469-6699
Mailing Address - Fax:202-370-6210
Practice Address - Street 1:3924 MINNESOTA AVE NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-2661
Practice Address - Country:US
Practice Address - Phone:202-649-4699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-29
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1053914363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCRN1053194OtherLICENSE