Pamela Renee Ellis, R.N.

Individual provider Active NPI Community Health Registered Nurse · Pawnee, OK

NPI 1174897979 · NPPES record last updated Feb 27, 2012

Key facts

NPI
1174897979
Entity type
Individual (NPI type 1)
Primary specialty
Community Health Registered Nurse 163WC1500X
License
R72803 (OK)
Practice address
1201 Heritage Cir
Pawnee, OK 74058-3744
Phone
(918) 762-6724
Fax
(918) 762-2729
NPI assigned
Feb 27, 2012
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
R72803OKMDCommunity Health Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X R72803 OK Yes

Addresses

Primary practice location

1201 Heritage Cir
Pawnee, OK 74058-3744

Mailing address

1201 Heritage Cir
Pawnee, OK 74058-3744
Phone (918) 762-6724

Other providers in Pawnee, OK

All providers in Pawnee, OK · Community Health Registered Nurse in Oklahoma

Sources for this page

Verify at the official NPI Registry.