Healthcare Provider Details

I. General information

NPI: 1629157953
Provider Name (Legal Business Name): PAMELA ERICKSON ROSSER CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PAMELA LOUISE ERICKSON RN

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 10/22/2021
Certification Date: 10/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 TREE FARM RD SUITE A110
PENNINGTON NJ
08534
US

IV. Provider business mailing address

2 TREE FARM RD SUITE A110
PENNINGTON NJ
08534
US

V. Phone/Fax

Practice location:
  • Phone: 609-737-7512
  • Fax: 609-737-0978
Mailing address:
  • Phone: 609-737-7512
  • Fax: 609-737-0978

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number26NR06094700
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number25ME00022301
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number25ME0002223
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: