Healthcare Provider Details

I. General information

NPI: 1982986337
Provider Name (Legal Business Name): PAMELA S HATFIELD FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2011
Last Update Date: 09/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HC 70, BOX 151
LENORE WV
25676-0137
US

IV. Provider business mailing address

PO BOX 137
LENORE WV
25676-0137
US

V. Phone/Fax

Practice location:
  • Phone: 304-475-2251
  • Fax:
Mailing address:
  • Phone: 304-475-2251
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number64585
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: