Provider Demographics
NPI:1851651798
Name:KELCH, PAMELA J (RN)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:J
Last Name:KELCH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:PAMELA
Other - Middle Name:J
Other - Last Name:NUNN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17 WOOD CLIFF WAY
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45121
Mailing Address - Country:US
Mailing Address - Phone:937-515-9077
Mailing Address - Fax:
Practice Address - Street 1:17 WOOD CLIFF WAY
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:OH
Practice Address - Zip Code:45121
Practice Address - Country:US
Practice Address - Phone:937-515-9077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-25
Last Update Date:2012-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN254420163W00000X, 163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WH0200XNursing Service ProvidersRegistered NurseHome Health