Healthcare Provider Details

I. General information

NPI: 1730465956
Provider Name (Legal Business Name): PAMELA ANN CARDWELL NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2011
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1211 OLD MAIN ST
HARTFORD KY
42347-1619
US

IV. Provider business mailing address

PO BOX 148
HARTFORD KY
42347-0148
US

V. Phone/Fax

Practice location:
  • Phone: 270-298-7411
  • Fax: 270-298-3824
Mailing address:
  • Phone: 270-504-1910
  • Fax: 270-298-3824

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN179147
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number3011363
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: