Provider Demographics
NPI:1972869824
Name:BINNIE, PAMELA (NP)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:BINNIE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 HOLLAND WAY FL 1
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-2997
Mailing Address - Country:US
Mailing Address - Phone:603-580-6457
Mailing Address - Fax:603-580-6428
Practice Address - Street 1:5 ALUMNI DR
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833
Practice Address - Country:US
Practice Address - Phone:603-580-6457
Practice Address - Fax:603-580-6428
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-04
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2264625363LA2200X
NH078502-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3113554Medicaid