| Doctor Name: | MRS. PAMELA RYDER FOX |
| NPI Number: | 1073704029 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APRN.FNP |
| License Number: | CNP81823 |
| Business Practice Address: | 25 Long Creek Dr South Portland, ME - 041062440 |
| Business Phone Number: | 2078790094 |
| Business Fax Number: | 2078790095 |
| Mailing Address: | 25 Long Creek Dr, SOUTH PORTLAND |
| State: | ME |
| Postal Code: | 041062440 |
| Phone Number: | 2078790094 |
| Fax Number: | 2078790095 |
| NPI Enumeration Date: | 08/06/2007 |
| NPI Last Update Date: | 10/07/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | CNP81823 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ME |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |