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General NPI Number Information
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NPI Number | 1669822847
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Entity Type | Individual
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Provider Name | PATRESHA PAMELLA PEARSON MSN BSN RN
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Gender | Female
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Dates
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Enumeration Date | 06/17/2016
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Last Update Date | 06/17/2016
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Provider Practice Location Address
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Address Line | 200 E KNOX RD LOT 44
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City | CHANDLER
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State | AZ
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Zip | 85225-3325
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Country | US
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Telephone | 760-402-6788
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Fax |
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Provider Business Mailing Address
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Address Line | 200 E KNOX RD LOT 44
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City | CHANDLER
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State | AZ
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Zip | 85225-3325
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Country | US
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Telephone | 760-402-6788
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Fax |
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 127955
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number | RN 127955
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 374T00000X
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Taxonomy Name | Religious Nonmedical Nursing Personnel
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License Number | 631334
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License Number State | CA
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