Provider Demographics
NPI:1508254848
Name:WEITZEL, PAMELA JUNE (CNM)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:JUNE
Last Name:WEITZEL
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3555 LUTHERAN PARKWAY SUITE 210
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033
Mailing Address - Country:US
Mailing Address - Phone:303-467-2800
Mailing Address - Fax:303-467-2861
Practice Address - Street 1:3555 LUTHERAN PARKWAY SUITE 210
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033
Practice Address - Country:US
Practice Address - Phone:303-467-2800
Practice Address - Fax:303-467-2861
Is Sole Proprietor?:No
Enumeration Date:2015-01-08
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO107035176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO107035OtherCERTIFIED NURSE MIDWIFE