Provider Demographics
NPI:1215447388
Name:SARTIN, PAMELA LEAH (RN)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:LEAH
Last Name:SARTIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:LEAH
Other - Last Name:MOSES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6350 W ANDREW JOHNSON HWY DEPT 100
Mailing Address - Street 2:
Mailing Address - City:TALBOTT
Mailing Address - State:TN
Mailing Address - Zip Code:37877-8605
Mailing Address - Country:US
Mailing Address - Phone:800-355-3565
Mailing Address - Fax:423-714-2355
Practice Address - Street 1:3360 HIGHWAY 411 N
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:TN
Practice Address - Zip Code:37329-5276
Practice Address - Country:US
Practice Address - Phone:423-887-5131
Practice Address - Fax:423-887-5917
Is Sole Proprietor?:No
Enumeration Date:2017-10-03
Last Update Date:2017-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN200422163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse