=====================================================
General NPI Number Information
=====================================================
NPI Number | 1023422300
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | PAMELA JONES COPE APRN-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/16/2014
-----------------------------------------------------
Last Update Date | 05/30/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1425 HAND AVE STE D
-----------------------------------------------------
City | ORMOND BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32174-1136
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 386-843-3132
-----------------------------------------------------
Fax | 386-243-7212
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1425 HAND AVE STE D
-----------------------------------------------------
City | ORMOND BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32174-1136
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 386-843-3132
-----------------------------------------------------
Fax | 386-243-7212
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LA2200X
-----------------------------------------------------
Taxonomy Name | Adult Health Nurse Practitioner
-----------------------------------------------------
License Number | APRN11014496
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------