Provider Demographics
NPI:1679953327
Name:COUTURE, PAMELA A (ARNP)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:A
Last Name:COUTURE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17511 BRUCE B DOWNS BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-3211
Mailing Address - Country:US
Mailing Address - Phone:813-915-5459
Mailing Address - Fax:813-515-7955
Practice Address - Street 1:17511 BRUCE B DOWNS BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647
Practice Address - Country:US
Practice Address - Phone:813-915-5459
Practice Address - Fax:813-515-7955
Is Sole Proprietor?:No
Enumeration Date:2015-06-08
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.012727363L00000X
FLARNP9461525363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner