Provider Demographics
NPI:1811722259
Name:VALDEZ, PAMELA KRISTINE (IFSD)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:KRISTINE
Last Name:VALDEZ
Suffix:
Gender:F
Credentials:IFSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 N BROWN AVE
Mailing Address - Street 2:
Mailing Address - City:NEGAUNEE
Mailing Address - State:MI
Mailing Address - Zip Code:49866-1512
Mailing Address - Country:US
Mailing Address - Phone:313-635-6107
Mailing Address - Fax:
Practice Address - Street 1:317 N BROWN AVE
Practice Address - Street 2:
Practice Address - City:NEGAUNEE
Practice Address - State:MI
Practice Address - Zip Code:49866-1512
Practice Address - Country:US
Practice Address - Phone:313-635-6107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-05
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula