Provider Demographics
NPI:1881959203
Name:WIRLEN, PAMELA NCHITU
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:NCHITU
Last Name:WIRLEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2420 ARTESIAN LN
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-3802
Mailing Address - Country:US
Mailing Address - Phone:301-379-4399
Mailing Address - Fax:
Practice Address - Street 1:2420 ARTESIAN LN
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-3802
Practice Address - Country:US
Practice Address - Phone:301-379-4399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-11
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X, 374U00000X
DCRN500022576163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No251S00000XAgenciesCommunity/Behavioral Health
No374U00000XNursing Service Related ProvidersHome Health Aide