Provider Demographics
NPI:1912129941
Name:ZUIDEMA, PAMELA JEAN (RN)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:JEAN
Last Name:ZUIDEMA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 REDBUD CIR
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:TN
Mailing Address - Zip Code:37355-3319
Mailing Address - Country:US
Mailing Address - Phone:931-581-3832
Mailing Address - Fax:
Practice Address - Street 1:1330 CEDAR LN STE 1100
Practice Address - Street 2:
Practice Address - City:TULLAHOMA
Practice Address - State:TN
Practice Address - Zip Code:37388-3277
Practice Address - Country:US
Practice Address - Phone:931-461-2663
Practice Address - Fax:931-461-2664
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000115472163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse