Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | 235425 | AZ |
NPI | 1023697992 |
---|---|
Provider Name | Pamela Love Batcheldor |
First Address | Tucson, AZ 85737-7249 |
Second Address | Tucson, AZ 85723-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2021 |
Last Update Date | 06/04/2021 |