Individual
PAMELA M BRISSETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
164 SUMMIT AVE # C70, PROVIDENCE, RI 02906-2853
(401) 793-4545
(401) 793-7866
Mailing address
PO BOX 16149, RUMFORD, RI 02916-0697
(401) 453-9625
(401) 435-7069
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA00147
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27118-1
BLUE CROSS
RI
01
—
411429
BLUECHIP
RI
Enumeration date
03/07/2006
Last updated
01/29/2020
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