Provider Demographics
NPI:1245290642
Name:STAFFORD, PAMELA KAREN (FNP)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:KAREN
Last Name:STAFFORD
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7446 QUESADA AVE
Mailing Address - Street 2:
Mailing Address - City:ELMENDORF AFB
Mailing Address - State:AK
Mailing Address - Zip Code:99506-1224
Mailing Address - Country:US
Mailing Address - Phone:910-551-1122
Mailing Address - Fax:
Practice Address - Street 1:ZEAMER STREET
Practice Address - Street 2:
Practice Address - City:ELMENDORF AFB
Practice Address - State:AK
Practice Address - Zip Code:99506
Practice Address - Country:US
Practice Address - Phone:907-580-2962
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-28
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9292026363LF0000X
TX650362363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily