1629607726 NPI number — PAMELA RAMSEY M.A., PC-IT

Table of content: PAMELA RAMSEY M.A., PC-IT (NPI 1629607726)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629607726 NPI number — PAMELA RAMSEY M.A., PC-IT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RAMSEY
Provider First Name:
PAMELA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.A., PC-IT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1629607726
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/18/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9000 W WISCONSIN AVE # MS 958
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MILWAUKEE
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
53226-4874
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
414-266-7615
Provider Business Mailing Address Fax Number:
414-266-6238

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
620 S 76TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MILWAUKEE
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53214-1599
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
414-453-1400
Provider Business Practice Location Address Fax Number:
414-453-2538
Provider Enumeration Date:
04/02/2020

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1629607726 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".




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