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NPI Code Detail

MEDICARE: PAMELA ABRAHAM NP

MEDICARE: PAMELA ABRAHAM NP
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
1363L00000XNurse Practitioner21739SC
2363L00000XNurse Practitioner5010396NC

General Provider Information

NPI Number : 1528050440
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAMELA ABRAHAM NP
Provider Business Mailing Address
First Line : PO BOX 19305
Second Line :
City : CHARLOTTE
State : NC
Zip : 28219-9305
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1021 MOREHEAD MEDICAL DR
Second Line : STE A
City : CHARLOTTE
State : NC
Zip : 28204-2990
Country : US
Telephone Number : 980-442-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/17/2005
Last Update Date : 01/05/2022

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