Provider Demographics
NPI:1508376849
Name:JEPPSON, PAMELA JENNER (PA-C)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:JENNER
Last Name:JEPPSON
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:280 CHESTNUT STREET
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01199-1001
Mailing Address - Country:US
Mailing Address - Phone:413-794-5700
Mailing Address - Fax:
Practice Address - Street 1:21 DWIGHT ROAD
Practice Address - Street 2:SUIT 105
Practice Address - City:LONGMEADOW
Practice Address - State:MA
Practice Address - Zip Code:01106
Practice Address - Country:US
Practice Address - Phone:413-794-5600
Practice Address - Fax:413-794-2733
Is Sole Proprietor?:No
Enumeration Date:2017-09-30
Last Update Date:2019-06-17
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Provider Licenses
StateLicense IDTaxonomies
MAPA6387363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical