Buckallew, Pamela Sue

Buckallew, Pamela Sue is an individual health care provider with primary practice located at 4311 Salisbury Road , Jacksonville FL 32216. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Allopathic & Osteopathic Physicians / Emergency Medicine. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Buckallew, Pamela Sue can be contacted via phone (904) 332-4316.

Contact Information

Primary practice address
4311 Salisbury Road Jacksonville FL 32216
Fax: (904) 332-4339
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X ARNP1663702 Florida
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X ARNP1663702 Florida

Profile Details

NPI number 1043279466
LBN Legal business name Buckallew, Pamela Sue
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 23rd, 2006
Last updated Jun 12th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043279466 NPPES
Florida MEDICAID 302869100

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