Provider Demographics
NPI:1962629634
Name:DEMONE, PAMELA M (APRN-BC, PMHNP, FNP)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:M
Last Name:DEMONE
Suffix:
Gender:F
Credentials:APRN-BC, PMHNP, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:318 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79601-5722
Mailing Address - Country:US
Mailing Address - Phone:325-672-7055
Mailing Address - Fax:325-672-7066
Practice Address - Street 1:318 CEDAR ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-5722
Practice Address - Country:US
Practice Address - Phone:325-672-7055
Practice Address - Fax:325-672-7066
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX626151363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXS93294Medicare UPIN