Healthcare Provider Details

I. General information

NPI: 1225553597
Provider Name (Legal Business Name): PAMELA WINLAND SW ASSISTANT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 HOSPITAL DR
ATHENS OH
45701-2301
US

IV. Provider business mailing address

90 HOSPITAL DR
ATHENS OH
45701-2301
US

V. Phone/Fax

Practice location:
  • Phone: 740-592-3091
  • Fax: 740-773-3985
Mailing address:
  • Phone: 740-592-3091
  • Fax: 740-773-3985

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: