Provider Demographics
NPI:1285781328
Name:COOMBS, PAMELA ELAINE (APRN)
Entity type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:ELAINE
Last Name:COOMBS
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 1:69 BUCKINGHAM ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01109-3926
Mailing Address - Country:US
Mailing Address - Phone:413-733-0408
Mailing Address - Fax:
Practice Address - Street 1:287 WEST ST
Practice Address - Street 2:
Practice Address - City:ROCKY HILL
Practice Address - State:CT
Practice Address - Zip Code:06067-3501
Practice Address - Country:US
Practice Address - Phone:860-721-5976
Practice Address - Fax:860-721-5953
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002597363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health