Provider Demographics
NPI:1922613843
Name:WILLIAMSON, PAMELA (INDEPENDENT PROVIDER)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:INDEPENDENT PROVIDER
Other - Prefix:MISS
Other - First Name:PAMELA
Other - Middle Name:
Other - Last Name:GREEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:25081 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-2603
Mailing Address - Country:US
Mailing Address - Phone:216-338-2709
Mailing Address - Fax:
Practice Address - Street 1:25081 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44117-2603
Practice Address - Country:US
Practice Address - Phone:216-338-2709
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-09
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health