Provider Demographics
NPI:1811990583
Name:TROOP, PAMELA ANN (RN, FNP, CNM)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:ANN
Last Name:TROOP
Suffix:
Gender:F
Credentials:RN, FNP, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7050 N RECREATION AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-8001
Mailing Address - Country:US
Mailing Address - Phone:559-322-2900
Mailing Address - Fax:559-322-2901
Practice Address - Street 1:7050 N RECREATION AVE STE 102
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-8001
Practice Address - Country:US
Practice Address - Phone:559-322-2900
Practice Address - Fax:559-322-2901
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-24
Last Update Date:2014-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANMW1250367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0085541Medicaid
CAGR0085540Medicaid