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General NPI Number Information
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NPI Number | 1518101971
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Entity Type | Individual
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Provider Name | PAMELA MELISSA WAINER APRN, CPNP-AC
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Gender | Female
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Dates
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Enumeration Date | 04/28/2009
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Last Update Date | 05/24/2022
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Provider Practice Location Address
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Address Line | 5750 PINELAND DR STE 260
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City | DALLAS
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State | TX
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Zip | 75231-5300
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Country | US
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Telephone | 469-637-4204
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Fax | 469-637-4586
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Provider Business Mailing Address
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Address Line | 5750 PINELAND DR STE 260
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City | DALLAS
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State | TX
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Zip | 75231-5300
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Country | US
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Telephone | 469-637-4204
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Fax | 469-637-4586
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | AP117864
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License Number State | TX
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