Provider Demographics
NPI:1700081429
Name:SANDERS, PAMELA ANN (RN)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:ANN
Last Name:SANDERS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:PAMELA
Other - Middle Name:ANN
Other - Last Name:MIDDLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:3701 WOODCOCK DR
Mailing Address - Street 2:
Mailing Address - City:HEPHZIBAH
Mailing Address - State:GA
Mailing Address - Zip Code:30815-7401
Mailing Address - Country:US
Mailing Address - Phone:706-306-5438
Mailing Address - Fax:
Practice Address - Street 1:4115 COLUMBIA RD
Practice Address - Street 2:SUITE 5-324
Practice Address - City:MARTINEZ
Practice Address - State:GA
Practice Address - Zip Code:30907-0405
Practice Address - Country:US
Practice Address - Phone:706-306-5438
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN070514163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse