Provider Demographics
NPI:1891034179
Name:CLAPP, PAMELA (RNFA)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:CLAPP
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1426 MAGNOLIA RDG
Mailing Address - Street 2:
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71112-5042
Mailing Address - Country:US
Mailing Address - Phone:318-426-2363
Mailing Address - Fax:
Practice Address - Street 1:1426 MAGNOLIA RDG
Practice Address - Street 2:
Practice Address - City:BOSSIER CITY
Practice Address - State:LA
Practice Address - Zip Code:71112-5042
Practice Address - Country:US
Practice Address - Phone:318-426-2363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-06
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN086438163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant