Provider Demographics
NPI:1639288251
Name:STAMPFLI, PAMELA ANN (FNP)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:ANN
Last Name:STAMPFLI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:ANN
Other - Last Name:SIMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2 INNOVATION DR
Mailing Address - Street 2:SUITE140
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-5261
Mailing Address - Country:US
Mailing Address - Phone:864-295-1750
Mailing Address - Fax:864-295-1753
Practice Address - Street 1:2 INNOVATION DR
Practice Address - Street 2:SUITE140
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-5261
Practice Address - Country:US
Practice Address - Phone:864-295-1750
Practice Address - Fax:864-295-1753
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCF910363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
S17967Medicare UPIN
SC3968Medicare PIN