Provider Demographics
NPI:1760934483
Name:TANK-DILLINGHAM, PAMELA JEAN (APRN, CNP, DNP)
Entity type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:JEAN
Last Name:TANK-DILLINGHAM
Suffix:
Gender:
Credentials:APRN, CNP, DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 AUDUBON DR
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28804-1201
Mailing Address - Country:US
Mailing Address - Phone:828-222-0280
Mailing Address - Fax:828-800-9580
Practice Address - Street 1:17 AUDUBON DR
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28804-1201
Practice Address - Country:US
Practice Address - Phone:828-222-0280
Practice Address - Fax:828-800-9580
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-28
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT101.0137808363LP0808X
WV109634363LP0808X
AK205756363LP0808X
CT12.011217363LP0808X
DEL8-0010280363LP0808X
IAG183913363LP0808X
KS53-84240-101363LP0808X
KY3016217363LP0808X
MDAC004089363LP0808X
MARN2361086363LP0808X
NH085572-23363LP0808X
NYF405762-01363LP0808X
RIAPRN03601363LP0808X
SDCP002904363LP0808X
NC5008740363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SDCP002904OtherBOARD OF NURSING APRN
MAMCS007586BOtherRX AUTH
WV109634OtherBOARD OF NURSING APRN
WV9543OtherRX AUTH
WY3146OtherRX AUTH
CT12.011217OtherBOARD OF NURSING APRN
NC5008740OtherBOARD OF NURSING APRN
MARN2361086OtherBOARD OF NURSING APRN
RIAPRN03601OtherBOARD OF NURSING APRN
DEL8-0010280OtherBOARD OF NURSING APRN
AK205756OtherBOARD OF NURSING APRN
NYF405762-01OtherBOARD OF NURSING APRN
VT101.0137808OtherBOARD OF NURSING APRN
WY52604OtherBOARD OF NURSING APRN
KS53-84240-101OtherBOARD OF NURSING APRN
IAG183913OtherBOARD OF NURSING APRN
NH085572-23OtherBOARD OF NURSING APRN
KY3016217OtherBOARD OF NURSING APRN
MDAC004089OtherBOARD OF NURSING APRN