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General NPI Number Information
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NPI Number | 1780389676
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Entity Type | Individual
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Provider Name | PAMELA PASSARELLI MS
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Gender | Female
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Dates
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Enumeration Date | 03/31/2023
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Last Update Date | 03/31/2023
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Provider Practice Location Address
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Address Line | 3101 DENNY AVE STE 130
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City | PASCAGOULA
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State | MS
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Zip | 39581-5307
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Country | US
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Telephone | 228-809-5308
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Fax |
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Provider Business Mailing Address
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Address Line | 3109 SHADOW WOOD DR
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-5936
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Country | US
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Telephone | 228-875-6601
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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 | 224Y00000X
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Taxonomy Name | Clinical Exercise Physiologist
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License Number |
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License Number State | MS
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