Individual
MRS. PAMELA SUZANNE WENTWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
3333 W TECH RD STE 220, MIAMISBURG, OH 45342-0956
(937) 885-4475
(937) 885-3671
Mailing address
PO BOX 933432, CLEVELAND, OH 44193-0039
(937) 641-5072
(937) 641-6129
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
ARNP2619002
FL
363LP0200X
Pediatric Nurse Practitioner
ARNP2619002
FL
363LP2300X
Primary Care Nurse Practitioner
Primary
APRN.CNP.0032838
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0008997
—
OH
05
—
013225400
—
FL
01
—
ARNP2619002
MEDICAL LICENSE
FL
Enumeration date
01/27/2011
Last updated
11/08/2024
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