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NPI Code Detail

MEDICARE: PAMELA LONGMORE PNP-C

MEDICARE: PAMELA LONGMORE PNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0200XPediatric Nurse Practitioner58154WV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1386649242
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAMELA LONGMORE PNP-C
Provider Business Mailing Address
First Line : 2500 HOSPITAL DR
Second Line :
City : MARTINSBURG
State : WV
Zip : 25401-3402
Country : US
Telephone Number : 304-264-1000
Fax Number :
Provider Business Practice Location Address
First Line : 2500 HOSPITAL DR
Second Line :
City : MARTINSBURG
State : WV
Zip : 25401-3402
Country : US
Telephone Number : 304-264-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2005
Last Update Date : 03/28/2016

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Directions to “ PAMELA LONGMORE PNP-C” Practice Location

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