Provider Demographics
NPI:1629157953
Name:ROSSER, PAMELA ERICKSON (CNM)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:ERICKSON
Last Name:ROSSER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:LOUISE
Other - Last Name:ERICKSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2 TREE FARM RD
Mailing Address - Street 2:SUITE A110
Mailing Address - City:PENNINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08534
Mailing Address - Country:US
Mailing Address - Phone:609-737-7512
Mailing Address - Fax:609-737-0978
Practice Address - Street 1:2 TREE FARM RD
Practice Address - Street 2:SUITE A110
Practice Address - City:PENNINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08534
Practice Address - Country:US
Practice Address - Phone:609-737-7512
Practice Address - Fax:609-737-0978
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR06094700163W00000X
NJ25ME00022301176B00000X
NJ25ME0002223176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No163W00000XNursing Service ProvidersRegistered Nurse