Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 11002920 | FL |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 11002920 | FL |
NPI | 1023636941 |
---|---|
Provider Name | Pamela Patrice Ward |
First Address | Sandy Springs, GA 30328-5918 |
Second Address | Atlanta, GA 30328-8156 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2020 |
Last Update Date | 07/07/2020 |