Provider Demographics
NPI:1952556227
Name:FERNANDEZ, PAMELA (RN)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:FERNANDEZ
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 1:54 SHOREVIEW DR
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-1933
Mailing Address - Country:US
Mailing Address - Phone:914-274-8207
Mailing Address - Fax:
Practice Address - Street 1:54 SHOREVIEW DR
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-1933
Practice Address - Country:US
Practice Address - Phone:914-274-8207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-29
Last Update Date:2008-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY139685576163W00000X, 163WE0003X, 163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163W00000XNursing Service ProvidersRegistered Nurse
No163WE0003XNursing Service ProvidersRegistered NurseEmergency