Provider Demographics
NPI:1629182894
Name:GROCER, PAMELA J (RNCS)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:J
Last Name:GROCER
Suffix:
Gender:F
Credentials:RNCS
Other - Prefix:
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Mailing Address - Street 1:1140 SOUTH RD
Mailing Address - Street 2:
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818
Mailing Address - Country:US
Mailing Address - Phone:401-486-0772
Mailing Address - Fax:401-732-2875
Practice Address - Street 1:1130 TEN ROD ROAD
Practice Address - Street 2:C250 B2
Practice Address - City:N, KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02852
Practice Address - Country:US
Practice Address - Phone:401-486-0772
Practice Address - Fax:401-732-3637
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RIPNS00005364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI898021145Medicare PIN