Provider Demographics
NPI:1760805188
Name:ROSEN, PAMELA (APRN)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:
Last Name:ROSEN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 CONSTITUTION DR STE 1L
Mailing Address - Street 2:ELLIOT FAMILY PRACTICE AT BEDFORD VILLAGE
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-6002
Mailing Address - Country:US
Mailing Address - Phone:603-472-7233
Mailing Address - Fax:
Practice Address - Street 1:15 CONSTITUTION DR STE 1L
Practice Address - Street 2:ELLIOT FAMILY PRACTICE AT BEDFORD VILLAGE
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6002
Practice Address - Country:US
Practice Address - Phone:603-472-7233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-22
Last Update Date:2017-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH051917-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily