MEDICARE: MRS. PAMELA. ADSIT R.N.

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
1	163W00000X	Registered Nurse	160634-030	WI

General Provider Information

NPI Number	:	1528396975
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. PAMELA. ADSIT R.N.

Provider Business Mailing Address
First Line	:	W1446 LAWLOR RD
Second Line	:
City	:	EAST TROY
State	:	WI
Zip	:	53120-2542
Country	:	US
Telephone Number	:	262-642-9535
Fax Number	:	262-642-9535

Provider Business Practice Location Address
First Line	:	W1446 LAWLOR RD
Second Line	:
City	:	EAST TROY
State	:	WI
Zip	:	53120-2542
Country	:	US
Telephone Number	:	262-642-9535
Fax Number	:	262-642-9535

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/23/2009
Last Update Date	:	11/23/2009

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