Provider Demographics
NPI:1184023764
Name:CARPENTER, PAMELA (CNP)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 CHERRY OCA LN
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-5601
Mailing Address - Country:US
Mailing Address - Phone:508-596-3990
Mailing Address - Fax:
Practice Address - Street 1:29 DEER PATH LN
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:MA
Practice Address - Zip Code:02493-1139
Practice Address - Country:US
Practice Address - Phone:781-642-1912
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-19
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN264413363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily