| Doctor Name: | PAMELA ANDERSON |
| NPI Number: | 1932273398 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | 67831-030 |
| Business Practice Address: | 11202 79 Street Pleasant Prairie, WI - 53158 |
| Business Phone Number: | 2626948468 |
| Business Fax Number: | |
| Mailing Address: | 11202 79 Street, PLEASANT PRAIRIE |
| State: | WI |
| Postal Code: | 53158 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 11/20/2006 |
| NPI Last Update Date: | 11/15/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WH0200X |
| License Number: | 67831-030 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WI |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Home Health |
| Taxonomy Definition: | |