Provider Demographics
NPI:1295705895
Name:ESTES, PAMELA K (ARNP)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:K
Last Name:ESTES
Suffix:
Gender:F
Credentials:ARNP
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 4557
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50306-4557
Mailing Address - Country:US
Mailing Address - Phone:515-280-7004
Mailing Address - Fax:515-280-9525
Practice Address - Street 1:907 W TOWNLINE ST
Practice Address - Street 2:
Practice Address - City:CRESTON
Practice Address - State:IA
Practice Address - Zip Code:50801-1126
Practice Address - Country:US
Practice Address - Phone:641-782-8244
Practice Address - Fax:641-782-6527
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA084106363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
P72286Medicare UPIN
I0784Medicare ID - Type Unspecified