Healthcare Provider Details

I. General information

NPI: 1073371068
Provider Name (Legal Business Name): PAMELA SYKES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/13/2024
Last Update Date: 03/13/2024
Certification Date: 03/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10857 DELPHI DR
CAMBY IN
46113-9175
US

IV. Provider business mailing address

10857 DELPHI DR
CAMBY IN
46113-9175
US

V. Phone/Fax

Practice location:
  • Phone: 317-992-4123
  • Fax:
Mailing address:
  • Phone: 317-992-4123
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number230161681
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: