Pamela K Tetrault, LPN
Individual provider Active NPI Licensed Practical Nurse · Shiloh, OH
NPI 1841422011 · NPPES record last updated Aug 20, 2009
Key facts
- NPI
- 1841422011
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- PN100580 (OH)
- Practice address
- 7402 State Route 13 N
Shiloh, OH 44878-8944 - Phone
- (419) 631-5838
- NPI assigned
- Aug 20, 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
| License | State | Type | Specialty |
|---|---|---|---|
| PN100580 | OH | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | PN100580 | OH | Yes |
Addresses
Primary practice location
7402 State Route 13 N
Shiloh, OH 44878-8944
Mailing address
7402 State Route 13 N
Shiloh, OH 44878-8944
Phone (419) 631-5838
Other providers in Shiloh, OH
- Ashley Ohl-Schiffer
- Jessica Brooke Parmer
- Paul Joseph Rudiak
- Tammy Lynn Shepherd
- Shiloh Medical Services, LLC
- Joy Lee Welch
- Sherry A Welch
All providers in Shiloh, OH · Licensed Practical Nurse in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 20, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.