MEDICARE: MRS. PAMELA BRELAND APRNBC, FNP

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	363LF0000X	Family Nurse Practitioner	R513326	MS

General Provider Information

NPI Number	:	1891888616
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. PAMELA BRELAND APRNBC, FNP

Provider Business Mailing Address
First Line	:	6935 WINDCHASE DR
Second Line	:
City	:	HORN LAKE
State	:	MS
Zip	:	38637-1452
Country	:	US
Telephone Number	:	662-830-3827
Fax Number	:

Provider Business Practice Location Address
First Line	:	6935 WINDCHASE DR
Second Line	:
City	:	HORN LAKE
State	:	MS
Zip	:	38637-1452
Country	:	US
Telephone Number	:	662-830-3827
Fax Number	:

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

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	04/17/2025

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