Healthcare Provider Details

I. General information

NPI: 1043020837
Provider Name (Legal Business Name): PAMELA OHARA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/13/2025
Last Update Date: 01/13/2025
Certification Date: 01/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2250 HICKORY RD STE 140
PLYMOUTH MEETING PA
19462-1047
US

IV. Provider business mailing address

2221 OAKFIELD RD
WARRINGTON PA
18976-2008
US

V. Phone/Fax

Practice location:
  • Phone: 610-379-2904
  • Fax:
Mailing address:
  • Phone: 445-309-2019
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN675168
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: