Provider Demographics
NPI:1518101971
Name:WAINER, PAMELA MELISSA (APRN, CPNP-AC)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:MELISSA
Last Name:WAINER
Suffix:
Gender:F
Credentials:APRN, CPNP-AC
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Mailing Address - Street 1:5750 PINELAND DR STE 260
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-5300
Mailing Address - Country:US
Mailing Address - Phone:469-637-4204
Mailing Address - Fax:469-637-4586
Practice Address - Street 1:5750 PINELAND DR STE 260
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-5300
Practice Address - Country:US
Practice Address - Phone:469-637-4204
Practice Address - Fax:469-637-4586
Is Sole Proprietor?:No
Enumeration Date:2009-04-28
Last Update Date:2022-05-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXAP117864363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics