Healthcare Provider Details

I. General information

NPI: 1922370766
Provider Name (Legal Business Name): PAMELA JEAN HOHN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PAMELA JEAN DUDLEY

II. Dates (important events)

Enumeration Date: 02/08/2012
Last Update Date: 02/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 6TH AVE S DEPT. 6220
ST PETERSBURG FL
33701-4634
US

IV. Provider business mailing address

501 6TH AVE S DEPT. 6220
ST PETERSBURG FL
33701-4634
US

V. Phone/Fax

Practice location:
  • Phone: 727-767-1418
  • Fax: 727-767-2766
Mailing address:
  • Phone: 727-767-1418
  • Fax: 727-767-2766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number9323846
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number1305283
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: