| Doctor Name: | PAMELA GIBBS WENGER |
| NPI Number: | 1376743674 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | REGISTERED NURSE |
| License Number: | 1039079 |
| Business Practice Address: | 1596 Highway 33 South New Tazewell, TN - 37825 |
| Business Phone Number: | 4236262965 |
| Business Fax Number: | 4236262968 |
| Mailing Address: | 6350 W A J Hwy, Department 100 TALBOTT |
| State: | TN |
| Postal Code: | 37877 |
| Phone Number: | 8003553565 |
| Fax Number: | 4237142355 |
| NPI Enumeration Date: | 07/24/2007 |
| NPI Last Update Date: | 01/06/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0809X |
| License Number: | 1039079 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | KY |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Psych/Mental Health, Adult |
| Taxonomy Definition: | |