Provider Demographics
NPI:1528241668
Name:WADSWORTH, PAMELA J (NP)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:J
Last Name:WADSWORTH
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Gender:F
Credentials:NP
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Mailing Address - Street 1:601 JOHN ST
Mailing Address - Street 2:STE M318
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007-5341
Mailing Address - Country:US
Mailing Address - Phone:269-345-6197
Mailing Address - Fax:269-345-9734
Practice Address - Street 1:601 JOHN ST
Practice Address - Street 2:STE M318
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49007-5341
Practice Address - Country:US
Practice Address - Phone:269-345-6197
Practice Address - Fax:269-345-9734
Is Sole Proprietor?:No
Enumeration Date:2007-12-12
Last Update Date:2012-01-20
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Provider Licenses
StateLicense IDTaxonomies
MI4704224119363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health