Provider Demographics
NPI:1386316321
Name:LANFAIR, PAMELA KAY (NP)
Entity type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:KAY
Last Name:LANFAIR
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8977 SWEETWATER TRL
Mailing Address - Street 2:
Mailing Address - City:NINEVEH
Mailing Address - State:IN
Mailing Address - Zip Code:46164-9323
Mailing Address - Country:US
Mailing Address - Phone:317-882-0335
Mailing Address - Fax:
Practice Address - Street 1:2100 N MAIN ST STE 304
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-1877
Practice Address - Country:US
Practice Address - Phone:574-546-1900
Practice Address - Fax:574-546-1999
Is Sole Proprietor?:No
Enumeration Date:2021-09-28
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN71011798A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily