Pamela Jean Bacom, APRN, RN
Nurse Practitioner in Daytona Beach, FL. Individual provider (NPI-1).
NPI number1275225898
StatusActive
Last updated in NPPESMay 22, 2024
Details
- NPI
- 1275225898
- Entity type
- Individual (NPI-1)
- Name
- Pamela Jean Bacom
- Credential
- APRN, RN
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 23, 2023
- Certification date
- May 22, 2024
- Last updated
- May 22, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | 11027349 | FL | Yes |
| 163WG0000X | Registered Nurse, General Practice | RN9488944 | FL |
Practice location
303 N Clyde Morris BlvdDaytona Beach, FL 32114-2709
Phone 386-425-4000
Mailing address
303 N Clyde Morris BlvdDaytona Beach, FL 32114-2709
Phone 386-425-4000
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