Basic Information
Provider Information
NPI: 1891291647
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BROWNSTEIN
FirstName: PAMELA
MiddleName: G
NamePrefix:  
NameSuffix:  
Credential: RN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 14423 NW 146TH TER
Address2:  
City: ALACHUA
State: FL
PostalCode: 326159344
CountryCode: US
TelephoneNumber: 3528713545
FaxNumber:  
Practice Location
Address1: 670 W FIREWEED LN STE 160
Address2:  
City: ANCHORAGE
State: AK
PostalCode: 995032561
CountryCode: US
TelephoneNumber: 9077700862
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/02/2018
LastUpdateDate: 09/24/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/23/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X181028AKY Nursing Service ProvidersRegistered Nurse 

No ID Information.


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