Basic Information
Provider Information
NPI: 1306875661
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHRISTALDI
FirstName: PAMELA
MiddleName: S
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 205 PAGE RD
Address2:  
City: PINEHURST
State: NC
PostalCode: 283748749
CountryCode: US
TelephoneNumber: 9102955511
FaxNumber:  
Practice Location
Address1: 102 GOSSMAN DRIVE
Address2:  
City: SOUTHERN PINES
State: NC
PostalCode: 28387
CountryCode: US
TelephoneNumber: 9102464140
FaxNumber: 9106952192
Other Information
ProviderEnumerationDate: 06/30/2006
LastUpdateDate: 01/23/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X900387NCY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


Home