Provider Demographics
NPI:1336951763
Name:THOMAS, PAMELA (AGPCNP-C)
Entity type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:AGPCNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 LEISURE CT
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-5724
Mailing Address - Country:US
Mailing Address - Phone:732-312-4828
Mailing Address - Fax:
Practice Address - Street 1:1 LEISURE CT
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-5724
Practice Address - Country:US
Practice Address - Phone:908-788-9292
Practice Address - Fax:908-788-0556
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-22
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15250100363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health