Individual
PAMELA RENEE BETHEL-WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4055 VALLEY VIEW LN, DALLAS, TX 75244-5074
(972) 715-3800
Mailing address
580 MAGNOLIA DR, DOUGLASVILLE, GA 30134-6634
(404) 395-7401
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
308544
NY
363LA2200X
Adult Health Nurse Practitioner
RN181956
GA
Other
Enumeration date
04/13/2018
Last updated
04/13/2018
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