Provider Demographics
NPI:1851655328
Name:VANDERVEEN, PAMELA J (RN)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:J
Last Name:VANDERVEEN
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 1:1125 W SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-3123
Mailing Address - Country:US
Mailing Address - Phone:913-715-7700
Mailing Address - Fax:913-826-1589
Practice Address - Street 1:6000 LAMAR AVE
Practice Address - Street 2:SUITE 130
Practice Address - City:MISSION
Practice Address - State:KS
Practice Address - Zip Code:66202-3234
Practice Address - Country:US
Practice Address - Phone:913-831-2550
Practice Address - Fax:913-826-1589
Is Sole Proprietor?:No
Enumeration Date:2012-06-29
Last Update Date:2012-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS73907163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse