Provider Demographics
NPI:1295770030
Name:FAUST, PAMELA ANN (RNBSN,CNOR,RNFA)
Entity type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:ANN
Last Name:FAUST
Suffix:
Gender:F
Credentials:RNBSN,CNOR,RNFA
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 1314
Mailing Address - Street 2:
Mailing Address - City:OCKLAWAHA
Mailing Address - State:FL
Mailing Address - Zip Code:32183-1314
Mailing Address - Country:US
Mailing Address - Phone:352-362-1130
Mailing Address - Fax:
Practice Address - Street 1:3320 SW 34TH CIR
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-3371
Practice Address - Country:US
Practice Address - Phone:352-629-8154
Practice Address - Fax:352-629-5231
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3024712163WS0121X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0121XNursing Service ProvidersRegistered NursePlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY1284OtherBCBS