Provider Demographics
NPI:1649424284
Name:ANDLER, PAMELA JOY (APRN-BC)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:JOY
Last Name:ANDLER
Suffix:
Gender:F
Credentials:APRN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1202 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-7307
Mailing Address - Country:US
Mailing Address - Phone:910-341-3300
Mailing Address - Fax:
Practice Address - Street 1:55 WHITCHER ST NE
Practice Address - Street 2:SUITE 350
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1155
Practice Address - Country:US
Practice Address - Phone:770-424-6893
Practice Address - Fax:678-819-0357
Is Sole Proprietor?:No
Enumeration Date:2008-11-10
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN157084363L00000X
NC5009671363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA844240223DMedicaid
GA844240223EMedicaid
GA844240223BMedicaid
GA844240223FMedicaid
GA844240223CMedicaid
GA844240223GMedicaid
GA844240223DMedicaid
GA844240223GMedicaid