Provider Demographics
NPI:1487126181
Name:COMEAU, PAMELA WOODBURN (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:WOODBURN
Last Name:COMEAU
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 MOUNT EUSTIS RD
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:NH
Mailing Address - Zip Code:03561-3712
Mailing Address - Country:US
Mailing Address - Phone:603-444-2462
Mailing Address - Fax:603-444-3441
Practice Address - Street 1:25 MOUNT EUSTIS RD
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:NH
Practice Address - Zip Code:03561-3712
Practice Address - Country:US
Practice Address - Phone:603-444-2462
Practice Address - Fax:603-444-3441
Is Sole Proprietor?:No
Enumeration Date:2018-12-19
Last Update Date:2020-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH068034-23363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health