Provider Demographics
NPI:1912062282
Name:BARROW, PAMELA J (RD, LN)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:J
Last Name:BARROW
Suffix:
Gender:F
Credentials:RD, LN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87999 BAR 25 RD
Mailing Address - Street 2:
Mailing Address - City:BASSETT
Mailing Address - State:NE
Mailing Address - Zip Code:68714-6191
Mailing Address - Country:US
Mailing Address - Phone:402-273-4015
Mailing Address - Fax:
Practice Address - Street 1:87999 BAR 25 RD
Practice Address - Street 2:
Practice Address - City:BASSETT
Practice Address - State:NE
Practice Address - Zip Code:68714-6191
Practice Address - Country:US
Practice Address - Phone:402-273-4015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2012-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD0324133N00000X
NE979422133V00000X
NE831133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist