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General NPI Number Information
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NPI Number | 1730392440
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Entity Type | Individual
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Provider Name | PAMELA NYGREN NCLC ABOC
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Gender | Female
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 926 E PRINCE RD
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City | TUCSON
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State | AZ
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Zip | 85719-1755
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Country | US
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Telephone | 520-293-2111
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Fax | 520-293-2112
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Provider Business Mailing Address
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Address Line | 926 E PRINCE RD
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City | TUCSON
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State | AZ
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Zip | 85719-1755
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Country | US
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Telephone | 520-293-2111
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Fax | 520-293-2112
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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 | 156FC0801X
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Taxonomy Name | Contact Lens Fitter
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License Number | 2164I
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License Number State | AZ
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