Provider Demographics
NPI:1740480946
Name:OUELLETTE, PAMELA A (NP)
Entity type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:A
Last Name:OUELLETTE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:281 LINCOLN ST
Mailing Address - Street 2:MEDICAL STAFF SERVICES
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-2138
Mailing Address - Country:US
Mailing Address - Phone:508-334-8015
Mailing Address - Fax:508-334-8235
Practice Address - Street 1:288 LYMAN ST
Practice Address - Street 2:DYS
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-2633
Practice Address - Country:US
Practice Address - Phone:508-836-3614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-25
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA150876363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner