Provider Demographics
NPI:1386605939
Name:HOWARD, PAMELA (APRN)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:HOWARD
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 1:5151 PARK AVE
Mailing Address - Street 2:SACRED HEART UNIVERSITY HEALTH SERVICES
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06825
Mailing Address - Country:US
Mailing Address - Phone:203-371-7838
Mailing Address - Fax:203-365-4743
Practice Address - Street 1:5151 PARK AVE
Practice Address - Street 2:SACRED HEART UNIVERITY HEALTH SERVICES
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06825-1090
Practice Address - Country:US
Practice Address - Phone:203-371-7838
Practice Address - Fax:203-365-4743
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001677363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTS63482Medicare UPIN
CT500000169Medicare ID - Type Unspecified