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General NPI Number Information
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NPI Number | 1386844561
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Entity Type | Individual
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Provider Name | PAMELA ELYSE KERSHAW DC
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Gender | Female
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Dates
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Enumeration Date | 07/25/2007
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Last Update Date | 07/25/2007
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Provider Practice Location Address
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Address Line | 2060 PALM BAY RD NE STE 5
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City | PALM BAY
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State | FL
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Zip | 32905-2931
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Country | US
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Telephone | 321-591-7450
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Fax | 321-951-1004
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Provider Business Mailing Address
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Address Line | 2691 ENGLEWOOD DR
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City | MELBOURNE
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State | FL
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Zip | 32940-7185
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Country | US
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Telephone | 321-242-5772
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Fax | 321-951-1004
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH0006237
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 6125
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License Number State | NY
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