Provider Demographics
NPI:1407294218
Name:KAISER, PAMELA ANN (FNP)
Entity type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:ANN
Last Name:KAISER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 E TUOLUMNE RD
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95382-1543
Mailing Address - Country:US
Mailing Address - Phone:209-668-4104
Mailing Address - Fax:
Practice Address - Street 1:911 E TUOLUMNE RD STE E
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95382-1543
Practice Address - Country:US
Practice Address - Phone:209-668-4104
Practice Address - Fax:209-668-3758
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-13
Last Update Date:2024-01-31
Deactivation Date:2024-01-20
Deactivation Code:
Reactivation Date:2024-01-24
Provider Licenses
StateLicense IDTaxonomies
CANP23147363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily