Basic Information
| Provider Information | |||||||||
| NPI: | 1760614838 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HANDLEY | ||||||||
| FirstName: | PAMELA | ||||||||
| MiddleName: | J. | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | ANP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12265 MARGARET DR | ||||||||
| Address2: | |||||||||
| City: | FENTON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 484308805 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8107500489 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2222 S LINDEN RD | ||||||||
| Address2: | SUITE A | ||||||||
| City: | FLINT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 485325475 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8107330790 | ||||||||
| FaxNumber: | 8107330235 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/21/2009 | ||||||||
| LastUpdateDate: | 10/15/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | 4704117621 | MI | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.