Individual
PAMELA GIBBS WENGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
1596 HIGHWAY 33 SOUTH, NEW TAZEWELL, TN 37825
(423) 626-2965
(423) 626-2968
Mailing address
6350 W A J HWY, DEPARTMENT 100, TALBOTT, TN 37877
(800) 355-3565
(423) 714-2355
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
1039079
KY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
APN12802
TN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN43930
TN
Other
Enumeration date
07/24/2007
Last updated
09/29/2020
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