Healthcare Provider Details

I. General information

NPI: 1629155841
Provider Name (Legal Business Name): PAMELA JOAN CHRISMAN N.P.,C.P.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 09/29/2026
Certification Date: 07/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 CHRISTIAN LN
SLIDELL LA
70458-1350
US

IV. Provider business mailing address

2900 INDIANA AVE
KENNER LA
70065-4605
US

V. Phone/Fax

Practice location:
  • Phone: 985-781-7353
  • Fax: 985-781-7354
Mailing address:
  • Phone: 504-575-3712
  • Fax: 504-575-3691

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAP06002
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN128025
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberR862193
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: