Individual provider Active NPI

Pamela Ruthann Tetlow, ARNP

  • Pediatric Registered Nurse
  • Tampa, FL
National Provider Identifier
1629124730
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Registered NurseTaxonomy code 163WP0200X
License
ARNP 9197916 Issued in FL
Practice address
7402 N 56TH St
906
Tampa, FL 33617-7733
Phone
(727) 536-4119
Fax
(727) 538-5529
NPI assigned
Jan 25, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Registered Nurse 163WP0200X ARNP 9197916 FL Primary

Addresses

Primary practice location

7402 N 56TH St
906
Tampa, FL 33617-7733

Mailing address

2071 N Pointe Alexis Dr
Tarpon Springs, FL 34689-2063
Phone (727) 942-8461

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
ARNP 9197916FLMDPediatric Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629124730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2071 N POINTE ALEXIS DR",
            "city": "TARPON SPRINGS",
            "state": "FL",
            "postal_code": "346892063",
            "telephone_number": "727-942-8461",
            "fax_number": "727-942-8637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7402 N 56TH ST",
            "address_2": "906",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336177733",
            "telephone_number": "727-536-4119",
            "fax_number": "727-538-5529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TETLOW",
        "first_name": "PAMELA",
        "middle_name": "RUTHANN",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "FL",
            "license": "ARNP 9197916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.