Individual
MRS. PAMELA R. WENTWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
349 S. MAIN ST., DAYTON, IA 45402
(937) 461-3450
(937) 461-9584
Mailing address
349 S. MAIN ST., DAYTON, IA 45402-2715
(937) 461-3450
(937) 461-9584
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
278653
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
278653
RN
OH
Enumeration date
09/20/2012
Last updated
09/20/2012
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