MEDICARE: PAMELA SUE KINGSEED

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	376J00000X	Homemaker

General Provider Information

NPI Number	:	1942072111
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAMELA SUE KINGSEED

Provider Business Mailing Address
First Line	:	PO BOX 142
Second Line	:
City	:	MC CUTCHENVILLE
State	:	OH
Zip	:	44844-0142
Country	:	US
Telephone Number	:	419-618-9266
Fax Number	:

Provider Business Practice Location Address
First Line	:	4255 W COUNTY ROAD 58
Second Line	:
City	:	MC CUTCHENVILLE
State	:	OH
Zip	:	44844-9623
Country	:	US
Telephone Number	:	419-618-9266
Fax Number	:

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

Provider Enumeration Date	:	10/23/2023
Last Update Date	:	10/23/2023

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Directions to “ PAMELA SUE KINGSEED ” Practice Location

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