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General NPI Number Information
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NPI Number | 1679435945
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Entity Type | Individual
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Provider Name | PAMELA RENEE ROSE NURSE
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Gender | Female
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Dates
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Enumeration Date | 11/25/2025
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Last Update Date | 11/25/2025
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Provider Practice Location Address
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Address Line | 388 BEN BOLT AVE
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City | TAZEWELL
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State | VA
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Zip | 24651-5386
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Country | US
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Telephone | 276-988-8850
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Fax |
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Provider Business Mailing Address
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Address Line | 7644 BURKES GARDEN RD
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City | TAZEWELL
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State | VA
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Zip | 24651-8528
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Country | US
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Telephone | 276-988-8863
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Fax | 276-988-5839
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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 | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number | 0001154149
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License Number State | VA
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