Provider Demographics
NPI:1952417206
Name:BEABER, PAMELA SUE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:SUE
Last Name:BEABER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3454 TIFFIN RD
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:OH
Mailing Address - Zip Code:43420-9541
Mailing Address - Country:US
Mailing Address - Phone:567-201-9694
Mailing Address - Fax:567-208-4114
Practice Address - Street 1:3454 TIFFIN RD
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:OH
Practice Address - Zip Code:43420-9541
Practice Address - Country:US
Practice Address - Phone:567-201-9694
Practice Address - Fax:567-208-4114
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN107723164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse