Provider Demographics
NPI:1457727240
Name:HALL, PAMELA (LPN)
Entity type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:
Last Name:HALL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MISS
Other - First Name:PAMELA
Other - Middle Name:
Other - Last Name:PRINGLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:909 ALAMEDA ST
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-5229
Mailing Address - Country:US
Mailing Address - Phone:405-360-5100
Mailing Address - Fax:
Practice Address - Street 1:909 ALAMEDA ST
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-5229
Practice Address - Country:US
Practice Address - Phone:405-360-5100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-14
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKL 0023744164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse