Doctor Name: | PAMELA DILLON |
NPI Number: | 1811030091 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | F.N.P |
License Number: | R831743 |
Business Practice Address: | 113 Enochs St Tylertown, MS - 396672711 |
Business Phone Number: | 6018763858 |
Business Fax Number: | 6018258130 |
Mailing Address: | 113 Enochs St, TYLERTOWN |
State: | MS |
Postal Code: | 396672711 |
Phone Number: | 6018763858 |
Fax Number: | 6018258130 |
NPI Enumeration Date: | 02/15/2007 |
NPI Last Update Date: | 04/15/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | R831743 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MS |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |