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General NPI Number Information
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NPI Number | 1023108180
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Entity Type | Individual
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Provider Name | PAMELA R ATKINSON MSN FNP-C
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Gender | Female
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 05/06/2020
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Provider Practice Location Address
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Address Line | 608 ROLLIE MOORE DR
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City | HARRISBURG
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State | IL
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Zip | 62946-2351
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Country | US
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Telephone | 618-997-5311
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Fax | 618-252-6595
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Provider Business Mailing Address
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Address Line | 608 ROLLIE MOORE DR
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City | HARRISBURG
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State | IL
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Zip | 62946-2351
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Country | US
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Telephone | 618-997-5311
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Fax | 618-252-6595
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 209001944
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License Number State | IL
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