Provider Demographics
NPI:1699764985
Name:WERSTLEIN, PAM O (PHD, APRN, BC, LPC)
Entity type:Individual
Prefix:MS
First Name:PAM
Middle Name:O
Last Name:WERSTLEIN
Suffix:
Gender:F
Credentials:PHD, APRN, BC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 TANGLE DR
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:NC
Mailing Address - Zip Code:27282-9413
Mailing Address - Country:US
Mailing Address - Phone:336-454-4382
Mailing Address - Fax:336-454-4382
Practice Address - Street 1:915 N GREENSBORO ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NC
Practice Address - Zip Code:27292-2699
Practice Address - Country:US
Practice Address - Phone:336-242-2300
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC84147363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily