Provider Demographics
NPI:1265774608
Name:NEIPER-REDO, PAMELA JEAN (LPN)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:JEAN
Last Name:NEIPER-REDO
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 W CAPE MAY AVE # 256
Mailing Address - Street 2:
Mailing Address - City:OCEAN GATE
Mailing Address - State:NJ
Mailing Address - Zip Code:08740-1326
Mailing Address - Country:US
Mailing Address - Phone:732-330-2969
Mailing Address - Fax:732-269-8180
Practice Address - Street 1:46 W CAPE MAY AVE # 256
Practice Address - Street 2:
Practice Address - City:OCEAN GATE
Practice Address - State:NJ
Practice Address - Zip Code:08740-1326
Practice Address - Country:US
Practice Address - Phone:732-330-2969
Practice Address - Fax:732-269-8180
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-24
Last Update Date:2013-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NP056595500251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care