Provider Demographics
NPI:1871840892
Name:KING, PAMELA DENISE (RN)
Entity type:Individual
Prefix:MISS
First Name:PAMELA
Middle Name:DENISE
Last Name:KING
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:PAMELA
Other - Middle Name:KING
Other - Last Name:DYE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1815 CRAWFORD DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28216-3508
Mailing Address - Country:US
Mailing Address - Phone:704-394-4824
Mailing Address - Fax:
Practice Address - Street 1:1601 BRENNER AVE
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-2515
Practice Address - Country:US
Practice Address - Phone:704-200-5850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-08
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC075657163WH0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0500XNursing Service ProvidersRegistered NurseHemodialysis