Healthcare Provider Details

I. General information

NPI: 1922042936
Provider Name (Legal Business Name): PAMELA JULIET CHAMBERS CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 N. NORTH NAVAJO
PAGE AZ
86040
US

IV. Provider business mailing address

2401 NORTHWIND DR
LITTLE ELM TX
75068-6853
US

V. Phone/Fax

Practice location:
  • Phone: 928-645-0165
  • Fax:
Mailing address:
  • Phone: 469-362-0098
  • Fax: 469-362-0090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number659231
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: