Healthcare Provider Details
I. General information
NPI: 1265983365
Provider Name (Legal Business Name): PAMELA WESTON NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/24/2016
Last Update Date: 11/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
26351 PATRIOTS WAY
GEORGETOWN DE
19947-2575
US
IV. Provider business mailing address
1275 S STATE ST
DOVER DE
19901-6927
US
V. Phone/Fax
- Phone: 302-933-3000
- Fax:
- Phone: 302-672-2319
- Fax: 302-672-2341
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | LG-0000968 |
| License Number State | DE |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: