Provider Demographics
NPI:1902248552
Name:MERRIWEATHER, PAMELA RENE (LPN)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:RENE
Last Name:MERRIWEATHER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3041 GETWELL RD STE 101
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38118-3737
Mailing Address - Country:US
Mailing Address - Phone:901-375-1050
Mailing Address - Fax:
Practice Address - Street 1:3041 GETWELL RD STE 101
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38118-3737
Practice Address - Country:US
Practice Address - Phone:901-375-1050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-24
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000051789164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse