Provider Demographics
NPI:1740256189
Name:BELLOW, PAMELA LOIS (FNP)
Entity type:Individual
Prefix:MISS
First Name:PAMELA
Middle Name:LOIS
Last Name:BELLOW
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6360 BOULDER HWY
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89122-7301
Mailing Address - Country:US
Mailing Address - Phone:725-228-4520
Mailing Address - Fax:877-889-5390
Practice Address - Street 1:6360 BOULDER HWY
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89122-7301
Practice Address - Country:US
Practice Address - Phone:725-228-4520
Practice Address - Fax:877-889-5390
Is Sole Proprietor?:No
Enumeration Date:2006-02-26
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX538632363LF0000X
NV002176363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV71963OtherMEDICARE
NV1740256189Medicaid
TX176208001Medicaid
S68620OtherMCR UPIN NUMBER
8D8464Medicare ID - Type UnspecifiedMCR PROVIDER NUMBER