Provider Demographics
NPI:1992947543
Name:GIESON, PAMELA SUE (RN)
Entity type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:SUE
Last Name:GIESON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10820 ROBINSON DR
Mailing Address - Street 2:
Mailing Address - City:BUNKER HILL
Mailing Address - State:IL
Mailing Address - Zip Code:62014-2809
Mailing Address - Country:US
Mailing Address - Phone:314-799-2731
Mailing Address - Fax:314-289-1169
Practice Address - Street 1:4050 LINDELL BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63108-3202
Practice Address - Country:US
Practice Address - Phone:314-658-2133
Practice Address - Fax:314-289-1169
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-28
Last Update Date:2009-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MORN136643163W00000X
IL041-294105163W00000X
KS101077163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse