Provider Demographics
NPI:1356875041
Name:WORTHINGTON, PAMELA SUE (DNP, APRN,FNP-BC,CWS)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:SUE
Last Name:WORTHINGTON
Suffix:
Gender:F
Credentials:DNP, APRN,FNP-BC,CWS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 S PARK DR
Mailing Address - Street 2:
Mailing Address - City:BROWNWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76801-5917
Mailing Address - Country:US
Mailing Address - Phone:325-649-3640
Mailing Address - Fax:325-649-3646
Practice Address - Street 1:123 S PARK DR
Practice Address - Street 2:
Practice Address - City:BROWNWOOD
Practice Address - State:TX
Practice Address - Zip Code:76801-5917
Practice Address - Country:US
Practice Address - Phone:325-649-3640
Practice Address - Fax:325-649-3646
Is Sole Proprietor?:No
Enumeration Date:2017-04-19
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP127448363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily