Pamela Wallack, REGISTERED NURSE

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN516572L Issued in PA

Practice address

669 Agency Main St
Harlem, MT 59526-9455

Phone

(406) 353-3100

Fax

(406) 353-3255

NPI assigned

Jan 9, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1483920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483920000000",
    "number": "1356887814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "669 AGENCY MAIN ST",
            "city": "HARLEM",
            "state": "MT",
            "postal_code": "595269455",
            "telephone_number": "406-353-3100",
            "fax_number": "406-353-3255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "669 AGENCY MAIN ST",
            "city": "HARLEM",
            "state": "MT",
            "postal_code": "595269455",
            "telephone_number": "406-353-3100",
            "fax_number": "406-353-3255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACK",
        "first_name": "PAMELA",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-09",
        "last_updated": "2017-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN516572L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mahmud Sabet Sogge-Kermani, PA-C
• Thu Tran
• U S Health Dept of Health & Human Services (Fort Belknap Health Center)
• Ijeoma C Uzoho, PHARMD
• Lorilane Walker
• Velvet Jean Werk, RN
• Mary Elizabeth Whitecow
• Sally Ann Wilhelm
• Megan Michelle Wilkie, RN
• Tawnya Therese Winchell, RN

• Registered Nurse in Harlem, MT
• Providers in Harlem, MT by specialty
• Registered Nurse in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.