Provider Demographics
NPI:1386258168
Name:WOLFORD, PAMELA SUE (CNA)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:SUE
Last Name:WOLFORD
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:SUE
Other - Last Name:KESNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:417 CENTER AVE
Mailing Address - Street 2:
Mailing Address - City:ROMNEY
Mailing Address - State:WV
Mailing Address - Zip Code:26757-1307
Mailing Address - Country:US
Mailing Address - Phone:304-359-8451
Mailing Address - Fax:
Practice Address - Street 1:417 CENTER AVE
Practice Address - Street 2:
Practice Address - City:ROMNEY
Practice Address - State:WV
Practice Address - Zip Code:26757-1307
Practice Address - Country:US
Practice Address - Phone:304-359-8451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-31
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant