Individual
MS. PAMELA JOY BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PCNS
Contact information
Practice address
1130 TEN ROD RD, BLDG D305, N.K, RI 02852
(401) 788-9573
Mailing address
1130 TEN ROD RD, BLDG D305, NORTH KINGSTOWN, RI 02852
(401) 789-4013
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
RN15994
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1020870
BEACON HEALTH
—
01
—
21221-4
RI BC/BS
RI
01
—
494590
TUFTS HEALTH PLAN
—
01
—
5366082
FIRST HEALTH
—
01
—
6236650
UNITED HEALTH CARE
—
Enumeration date
05/12/2006
Last updated
10/09/2013
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