| Doctor Name: | PAMELA RENEE ELLIS |
| NPI Number: | 1174897979 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | R.N. |
| License Number: | R72803 |
| Business Practice Address: | 1201 Heritage Cir Pawnee, OK - 740583744 |
| Business Phone Number: | 9187626724 |
| Business Fax Number: | 9187622729 |
| Mailing Address: | 1201 Heritage Cir, PAWNEE |
| State: | OK |
| Postal Code: | 740583744 |
| Phone Number: | 9187626724 |
| Fax Number: | 9187622729 |
| NPI Enumeration Date: | 02/27/2012 |
| NPI Last Update Date: | 02/27/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WC1500X |
| License Number: | R72803 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Community Health |
| Taxonomy Definition: | |