Pamela Beard, LPN

Individual provider Active NPI Licensed Practical Nurse · Wayne, MI

NPI 1003049321 · NPPES record last updated Sep 3, 2009

Key facts

NPI
1003049321
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
4703078688 (MI)
Practice address
33120 Forest Park Dr
Wayne, MI 48184-3312
Phone
(734) 634-3340
NPI assigned
Sep 3, 2009
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
4703078688MIMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 4703078688 MI Yes

Addresses

Primary practice location

33120 Forest Park Dr
Wayne, MI 48184-3312

Mailing address

33120 Forest Park Dr
Wayne, MI 48184-3312

Other providers in Wayne, MI

All providers in Wayne, MI · Licensed Practical Nurse in Michigan

Sources for this page

Verify at the official NPI Registry.