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General NPI Number Information
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NPI Number | 1285917633
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Entity Type | Individual
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Provider Name | PAMALA ANN WILSON L.M., C.P.M
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Gender | Female
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Dates
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Enumeration Date | 09/22/2011
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Last Update Date | 10/28/2025
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Provider Practice Location Address
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Address Line | 8180 REGENT PKWY
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City | FORT MILL
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State | SC
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Zip | 29715-8417
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Country | US
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Telephone | 518-368-3605
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Fax |
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Provider Business Mailing Address
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Address Line | 12330 TANTALLON CT
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City | PINEVILLE
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State | NC
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Zip | 28134-6410
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Country | US
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Telephone | 518-368-3605
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Fax | 704-731-0867
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number | LMW-0051
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License Number State | SC
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