Provider Demographics
NPI:1386677904
Name:FLOREA, PAMELA M (APRN CS)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:M
Last Name:FLOREA
Suffix:
Gender:F
Credentials:APRN CS
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:M
Other - Last Name:AHLERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN CS
Mailing Address - Street 1:100 FODEN ROAD WEST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-2327
Mailing Address - Country:US
Mailing Address - Phone:207-828-0361
Mailing Address - Fax:207-874-1483
Practice Address - Street 1:100 FODEN RD., WEST
Practice Address - Street 2:SUITE 100
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-2327
Practice Address - Country:US
Practice Address - Phone:207-523-3900
Practice Address - Fax:207-523-8593
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2010-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MER037525364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME432142599Medicaid
MEVX0763Medicare PIN