Provider Demographics
NPI:1316486723
Name:ARTERBURN, PAMELA
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:ARTERBURN
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:PO BOX 742
Mailing Address - Street 2:
Mailing Address - City:RED RIVER
Mailing Address - State:NM
Mailing Address - Zip Code:87558
Mailing Address - Country:US
Mailing Address - Phone:575-754-6117
Mailing Address - Fax:575-754-3258
Practice Address - Street 1:500 E HIGH STREET
Practice Address - Street 2:
Practice Address - City:RED RIVER
Practice Address - State:NM
Practice Address - Zip Code:87558
Practice Address - Country:US
Practice Address - Phone:575-754-6117
Practice Address - Fax:575-754-3258
Is Sole Proprietor?:No
Enumeration Date:2017-02-17
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR15737163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse