Provider Demographics
NPI:1932567021
Name:PRICE, PAMELA N (ARNP)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:N
Last Name:PRICE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:
Other - Last Name:GRANTHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1851 OLD MOULTRIE RD STE A
Mailing Address - Street 2:
Mailing Address - City:SAINT AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32084-4167
Mailing Address - Country:US
Mailing Address - Phone:904-824-8088
Mailing Address - Fax:904-826-4105
Practice Address - Street 1:1851 OLD MOULTRIE RD STE A
Practice Address - Street 2:
Practice Address - City:SAINT AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32084-4167
Practice Address - Country:US
Practice Address - Phone:904-824-8088
Practice Address - Fax:904-826-4105
Is Sole Proprietor?:No
Enumeration Date:2016-02-03
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN306592363LA2200X
FL3056592363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health