Provider Demographics
NPI:1063747855
Name:BLACK, PAMELA S (CD(DONA), CCE(ACBE))
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:S
Last Name:BLACK
Suffix:
Gender:F
Credentials:CD(DONA), CCE(ACBE)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1660 STEELE ST APT 202
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-1735
Mailing Address - Country:US
Mailing Address - Phone:303-862-8024
Mailing Address - Fax:
Practice Address - Street 1:1660 STEELE ST APT 202
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-1735
Practice Address - Country:US
Practice Address - Phone:303-862-8024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-12
Last Update Date:2009-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula