Healthcare Provider Details

I. General information

NPI: 1528359064
Provider Name (Legal Business Name): PAMELA A. MILSTEAD RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2011
Last Update Date: 05/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7305 N MILITARY TRL
RIVIERA BEACH FL
33410-7417
US

IV. Provider business mailing address

283 EDGE WATER DR
BRUNSWICK GA
31525-6873
US

V. Phone/Fax

Practice location:
  • Phone: 561-422-8262
  • Fax:
Mailing address:
  • Phone: 912-262-6453
  • Fax: 912-262-6453

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WI0600X
TaxonomyInfection Control Registered Nurse
License NumberRN9321200
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: