Provider Demographics
NPI:1134219322
Name:GUIDER, PAMELA R (APN, PMHNP, NP-PP)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:R
Last Name:GUIDER
Suffix:
Gender:F
Credentials:APN, PMHNP, NP-PP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 SW NYE ST
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:OR
Mailing Address - Zip Code:97365-3821
Mailing Address - Country:US
Mailing Address - Phone:865-482-1076
Mailing Address - Fax:865-481-6179
Practice Address - Street 1:240 WEST TYRONE ROAD
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830
Practice Address - Country:US
Practice Address - Phone:865-482-1076
Practice Address - Fax:865-481-6179
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201607736NP-PP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3929832OtherMEDICARE
TNP00156103OtherRAILROAD MEDICARE
TN4095658OtherBCBSOF TN
TNMG1144928OtherDEA
TNMG1144928OtherDEA
TNQ23682Medicare UPIN