Provider Demographics
NPI:1942575535
Name:PAMELA HARTSFIELD PLLC
Entity Type:Organization
Organization Name:PAMELA HARTSFIELD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:HARTSFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:919-415-2355
Mailing Address - Street 1:1135 KILDAIRE FARM RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-7608
Mailing Address - Country:US
Mailing Address - Phone:919-415-2355
Mailing Address - Fax:888-972-7585
Practice Address - Street 1:1135 KILDAIRE FARM RD
Practice Address - Street 2:SUITE 200
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-7608
Practice Address - Country:US
Practice Address - Phone:919-415-2355
Practice Address - Fax:888-972-7585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-14
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2153261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2817686AMedicare PIN