Healthcare Provider Details

I. General information

NPI: 1801009642
Provider Name (Legal Business Name): PAMELA SUE JANCE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2177 ASHEVILLE RD
WAYNESVILLE NC
28786
US

IV. Provider business mailing address

2835 MAX PATCH RD
CLYDE NC
28721
US

V. Phone/Fax

Practice location:
  • Phone: 828-452-6675
  • Fax:
Mailing address:
  • Phone: 828-627-6867
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number212205
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: