Provider Demographics
NPI:1063567964
Name:GEDNEY, PAMELA V (DNP, FNP-BC, APNP)
Entity type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:V
Last Name:GEDNEY
Suffix:
Gender:F
Credentials:DNP, FNP-BC, APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 909
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:52353-0909
Mailing Address - Country:US
Mailing Address - Phone:319-653-5481
Mailing Address - Fax:319-353-6406
Practice Address - Street 1:400 E POLK ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:IA
Practice Address - Zip Code:52353-1237
Practice Address - Country:US
Practice Address - Phone:319-653-5481
Practice Address - Fax:319-353-6406
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2018-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA-056296363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43952000Medicaid
014200238Medicare PIN
WI43952000Medicaid