Provider Demographics
NPI:1982841888
Name:FUTCH, PAMELA ADAMS (RNFA)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:ADAMS
Last Name:FUTCH
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:ADAMS
Other - Last Name:FUTCH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RNFA
Mailing Address - Street 1:3401 CHARLIE TAYLOR RD
Mailing Address - Street 2:
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33565-2519
Mailing Address - Country:US
Mailing Address - Phone:813-754-4062
Mailing Address - Fax:813-684-6043
Practice Address - Street 1:116 PARSONS PARK DR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-6066
Practice Address - Country:US
Practice Address - Phone:813-681-6625
Practice Address - Fax:813-684-6043
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-14
Last Update Date:2009-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0974672163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant