Provider Demographics
NPI:1871908749
Name:CHARNIN, PAMELA (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:
Last Name:CHARNIN
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2394 SW 8TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:BOYTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426
Mailing Address - Country:US
Mailing Address - Phone:516-388-3884
Mailing Address - Fax:516-694-3783
Practice Address - Street 1:2394 SW 8TH AVENUE
Practice Address - Street 2:
Practice Address - City:BOYTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426
Practice Address - Country:US
Practice Address - Phone:516-388-3884
Practice Address - Fax:516-694-3783
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-30
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY8617594363LF0000X
FL11007211363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily