1760934483 NPI number — DR. PAMELA JEAN TANK-DILLINGHAM DNP

Table of content: DR. PAMELA JEAN TANK-DILLINGHAM DNP (NPI 1760934483)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760934483 NPI number — DR. PAMELA JEAN TANK-DILLINGHAM DNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TANK-DILLINGHAM
Provider First Name:
PAMELA
Provider Middle Name:
JEAN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DNP
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:
1760934483
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/02/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
17 AUDUBON DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ASHEVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28804-1201
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-222-0280
Provider Business Mailing Address Fax Number:
828-800-9580

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
17 AUDUBON DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ASHEVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28804-1201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-222-0280
Provider Business Practice Location Address Fax Number:
828-800-9580
Provider Enumeration Date:
10/28/2016

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: 363L00000X , with the licence number:  245812 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363L00000X , with the licence number: 5008740 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: 245812 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: 5008740 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0808X , with the licence number: 245812 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0808X , with the licence number: 5008740 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: AN-0024953 . This is a "RX AUTH" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 3016217 . This is a "BOARD OF NURSING APRN" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: L8-0010280 . This is a "BOARD OF NURSING APRN" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 085572-23 . This is a "BOARD OF NURSING APRN" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: AC004089 . This is a "BOARD OF NURSING APRN" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: SP024259 . This is a "BOARD OF NURSING APRN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: N112496 . This is a "RX AUTH" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 9543 . This is a "RX AUTH" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: RN2361086 . This is a "BOARD OF NURSING APRN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: NPPA048146 . This is a "RX AUTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 11217 . This is a "BOARD OF NURSING APRN" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 109634 . This is a "BOARD OF NURSING APRN" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 5008740 . This is a "BOARD OF NURSING APRN" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: CSP.0082145 . This is a "RX AUTH" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: MCS007586B . This is a "RX AUTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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