Provider Demographics
NPI:1386884344
Name:BECKLES-PETERS, PAMELA MARGUERITA
Entity type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:MARGUERITA
Last Name:BECKLES-PETERS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:PAMELA
Other - Middle Name:MARGUERITA
Other - Last Name:BECKLES-PETERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NURSE
Mailing Address - Street 1:7226 WINTERFIELD TER
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-9481
Mailing Address - Country:US
Mailing Address - Phone:301-210-5453
Mailing Address - Fax:301-210-5453
Practice Address - Street 1:7226 WINTERFIELD TER
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-9481
Practice Address - Country:US
Practice Address - Phone:301-210-5453
Practice Address - Fax:301-210-5453
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-03
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLP40510164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse