Provider Demographics
NPI:1982005161
Name:SAUNDERS PANGBORN, PAMELA (LPN)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:
Last Name:SAUNDERS PANGBORN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:
Other - Last Name:SAUNDERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3604 COUNTY ROAD 31
Mailing Address - Street 2:
Mailing Address - City:GALION
Mailing Address - State:OH
Mailing Address - Zip Code:44833-9687
Mailing Address - Country:US
Mailing Address - Phone:419-462-7611
Mailing Address - Fax:
Practice Address - Street 1:3604 COUNTY ROAD 31
Practice Address - Street 2:
Practice Address - City:GALION
Practice Address - State:OH
Practice Address - Zip Code:44833-9687
Practice Address - Country:US
Practice Address - Phone:419-462-7611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-08
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN. 115623164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse