Provider Demographics
NPI:1881818862
Name:STONE, PAMELA TOMBERLIN I (RN)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:TOMBERLIN
Last Name:STONE
Suffix:I
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 1:421 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:GA
Mailing Address - Zip Code:31635-1419
Mailing Address - Country:US
Mailing Address - Phone:229-482-8164
Mailing Address - Fax:229-482-1074
Practice Address - Street 1:503 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:GA
Practice Address - Zip Code:31635-1421
Practice Address - Country:US
Practice Address - Phone:229-482-8164
Practice Address - Fax:229-482-1074
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN115881163W00000X, 163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered163WA2000XNursing Service ProvidersRegistered NurseAdministrator