Provider Demographics
NPI:1265778765
Name:KONAKIS, PAMELA J (RN)
Entity type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:J
Last Name:KONAKIS
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 1:377 N FAIRGROUNDS RD
Mailing Address - Street 2:P.O. BOX 1437
Mailing Address - City:PRICE
Mailing Address - State:UT
Mailing Address - Zip Code:84501-4241
Mailing Address - Country:US
Mailing Address - Phone:435-613-2200
Mailing Address - Fax:435-613-2201
Practice Address - Street 1:377 N FAIRGROUNDS RD
Practice Address - Street 2:
Practice Address - City:PRICE
Practice Address - State:UT
Practice Address - Zip Code:84501-4241
Practice Address - Country:US
Practice Address - Phone:435-613-2200
Practice Address - Fax:435-613-2201
Is Sole Proprietor?:No
Enumeration Date:2013-01-02
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT196768-3102163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator