Healthcare Provider Details

I. General information

NPI: 1861988545
Provider Name (Legal Business Name): MRS. PAMELA JEAN TOWER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2018
Last Update Date: 07/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 CHADBOURNE RD.
HARMONY ME
04942
US

IV. Provider business mailing address

PO BOX 245
HARMONY ME
04942-0245
US

V. Phone/Fax

Practice location:
  • Phone: 207-683-2006
  • Fax:
Mailing address:
  • Phone: 207-683-2006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number63544
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN63544
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: