Provider Demographics
NPI:1316101827
Name:EBERHARD, PAMELA BETH (CRNP)
Entity type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:BETH
Last Name:EBERHARD
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25699 HIGNUTT RD
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:MD
Mailing Address - Zip Code:21629-2456
Mailing Address - Country:US
Mailing Address - Phone:410-479-8000
Mailing Address - Fax:410-479-4864
Practice Address - Street 1:403 S 7TH ST
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:MD
Practice Address - Zip Code:21629-1327
Practice Address - Country:US
Practice Address - Phone:410-479-8000
Practice Address - Fax:410-479-4864
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-14
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR079115363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology