Provider Demographics
NPI:1912918160
Name:FOX, PAMELA L (LMHP, RN)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:L
Last Name:FOX
Suffix:
Gender:F
Credentials:LMHP, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14030 S 68TH ST.
Mailing Address - Street 2:
Mailing Address - City:ROCA
Mailing Address - State:NE
Mailing Address - Zip Code:68430
Mailing Address - Country:US
Mailing Address - Phone:402-792-3147
Mailing Address - Fax:
Practice Address - Street 1:701 P ST
Practice Address - Street 2:STE. 305
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68508-1356
Practice Address - Country:US
Practice Address - Phone:402-420-6621
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE411101YM0800X
NE30514163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered163W00000XNursing Service ProvidersRegistered Nurse