Provider Demographics
NPI:1184900524
Name:SHIMER, PAMELA ANN (RN)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:ANN
Last Name:SHIMER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 313
Mailing Address - Street 2:27 SNEED ST.
Mailing Address - City:WURTSBORO
Mailing Address - State:NY
Mailing Address - Zip Code:12790-0313
Mailing Address - Country:US
Mailing Address - Phone:845-888-4863
Mailing Address - Fax:
Practice Address - Street 1:69 RICHARDSON AVE
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:NY
Practice Address - Zip Code:12701-2212
Practice Address - Country:US
Practice Address - Phone:845-794-8830
Practice Address - Fax:845-794-8840
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-31
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYRN186211163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse