Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LF0000X | Nurse Practitioner - Family Medicine | 0991779 | CO |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 201408154NP-PP | OR |
N | 363LP0200X | Nurse Practitioner - Pediatrics | 30806.1182 | WY |
NPI | 1013164771 |
---|---|
Provider Name | Pamela Namenyi |
First Address | Englewood, CO 80112-5095 |
Second Address | Klamath Falls, OR 97601-3372 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2008 |
Last Update Date | 06/12/2021 |