Provider Demographics
NPI:1811258171
Name:SPIVEY, PAMELA M
Entity type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:M
Last Name:SPIVEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 BRYANT ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-1027
Mailing Address - Country:US
Mailing Address - Phone:202-706-8537
Mailing Address - Fax:
Practice Address - Street 1:71 BRYANT ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-1027
Practice Address - Country:US
Practice Address - Phone:202-706-8537
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-04
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide