Provider Demographics
NPI:1265618235
Name:BARTLEY, PAMELA SUE (ARNP)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:SUE
Last Name:BARTLEY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MS
Other - First Name:PAMELA
Other - Middle Name:SUE
Other - Last Name:WATSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:503 HERRINGTON WOODS
Mailing Address - Street 2:
Mailing Address - City:HARRODSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40330-9716
Mailing Address - Country:US
Mailing Address - Phone:859-748-9104
Mailing Address - Fax:
Practice Address - Street 1:1101 VETERANS DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40502-2235
Practice Address - Country:US
Practice Address - Phone:859-233-4511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-21
Last Update Date:2008-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3060P363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily