Provider Demographics
NPI:1124733027
Name:VEENKANT, PAMELA J
Entity type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:J
Last Name:VEENKANT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 1ST AVE SE APT 6
Mailing Address - Street 2:
Mailing Address - City:DICKINSON
Mailing Address - State:ND
Mailing Address - Zip Code:58601-5605
Mailing Address - Country:US
Mailing Address - Phone:701-301-9014
Mailing Address - Fax:
Practice Address - Street 1:130 1ST AVE SE APT 6
Practice Address - Street 2:
Practice Address - City:DICKINSON
Practice Address - State:ND
Practice Address - Zip Code:58601-5605
Practice Address - Country:US
Practice Address - Phone:701-301-9014
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-16
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant