Healthcare Provider Details

I. General information

NPI: 1699199778
Provider Name (Legal Business Name): PAMELA CORDER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2014
Last Update Date: 01/31/2025
Certification Date: 01/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 E COVE AVE
WHEELING WV
26003-5083
US

IV. Provider business mailing address

7 E COVE AVE
WHEELING WV
26003-5083
US

V. Phone/Fax

Practice location:
  • Phone: 304-242-0770
  • Fax: 304-242-3647
Mailing address:
  • Phone: 304-242-0770
  • Fax: 304-242-3647

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN37059
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.17011
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.17011
License Number StateOH
# 4
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN37059
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: