Basic Information
| Provider Information | |||||||||
| NPI: | 1336805043 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WEBSTER | ||||||||
| FirstName: | PAMELA | ||||||||
| MiddleName: | |||||||||
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| Credential: | RN, FNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 67 WILD FLOWER TRL | ||||||||
| Address2: | |||||||||
| City: | WAKEFIELD | ||||||||
| State: | RI | ||||||||
| PostalCode: | 028791437 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4017412928 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 268 POST RD STE 203 | ||||||||
| Address2: | |||||||||
| City: | WESTERLY | ||||||||
| State: | RI | ||||||||
| PostalCode: | 028916601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4016042530 | ||||||||
| FaxNumber: | 4016042560 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/17/2021 | ||||||||
| LastUpdateDate: | 12/09/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/09/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN65519 | RI | N | Nursing Service Providers | Registered Nurse | 363LF0000X | APRN02919 | RI | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.