Individual
PAMELA THORNTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
1717 S CALHOUN ST, FORT WAYNE, IN 46802-5257
(260) 458-2641
Mailing address
1717 S CALHOUN ST, FORT WAYNE, IN 46802-5257
(260) 458-2641
(260) 458-3093
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71008077A
IN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
71008077A
IN
Other
Enumeration date
06/28/2018
Last updated
07/15/2024
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