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General NPI Number Information
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NPI Number | 1487754065
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Entity Type | Individual
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Provider Name | PAMELA CELESTE SMITH FNP-C
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Gender | Female
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Dates
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Enumeration Date | 09/24/2006
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Last Update Date | 12/19/2016
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Provider Practice Location Address
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Address Line | 830 PENNSYLVANIA AVE STE 103
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City | CHARLESTON
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State | WV
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Zip | 25302-3389
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Country | US
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Telephone | 304-388-1552
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7000
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City | MORGANTOWN
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State | WV
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Zip | 26507-7000
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Country | US
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Telephone | 304-388-1552
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 52807
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License Number State | WV
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