Provider Demographics
NPI:1013658772
Name:LESAGE, PAMELA JEAN (RN)
Entity type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:JEAN
Last Name:LESAGE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 LOOP RD
Mailing Address - Street 2:
Mailing Address - City:SAVOY
Mailing Address - State:MA
Mailing Address - Zip Code:01256-9345
Mailing Address - Country:US
Mailing Address - Phone:413-664-1222
Mailing Address - Fax:
Practice Address - Street 1:7 LOOP RD
Practice Address - Street 2:
Practice Address - City:SAVOY
Practice Address - State:MA
Practice Address - Zip Code:01256-9345
Practice Address - Country:US
Practice Address - Phone:413-664-1222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-06
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN277736163WH0200X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WH0200XNursing Service ProvidersRegistered NurseHome Health