Provider Demographics
NPI:1891280335
Name:WELLS-ELAM, PAMELA (AGNP)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:WELLS-ELAM
Suffix:
Gender:F
Credentials:AGNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:733 SEYMOUR RD
Mailing Address - Street 2:
Mailing Address - City:BEAR
Mailing Address - State:DE
Mailing Address - Zip Code:19701-1106
Mailing Address - Country:US
Mailing Address - Phone:267-338-7207
Mailing Address - Fax:
Practice Address - Street 1:5 CHRISTY DR STE 103
Practice Address - Street 2:
Practice Address - City:CHADDS FORD
Practice Address - State:PA
Practice Address - Zip Code:19317-9667
Practice Address - Country:US
Practice Address - Phone:484-840-0811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-27
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE0000259363L00000X
PASPO19137363L00000X
DEL8-0010703363LP0808X
PARN602213163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health