Healthcare Provider Details
I. General information
NPI: 1780610170
Provider Name (Legal Business Name): PAMELA J PLUCINSKI PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/25/2006
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1300 DIVISION RD STE 301
WEST WARWICK RI
02893-7558
US
IV. Provider business mailing address
1075 SMITH ST STE 2
PROVIDENCE RI
02908-2700
US
V. Phone/Fax
- Phone: 401-369-9224
- Fax: 401-369-9275
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 364SP0807X |
| Taxonomy | Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist |
| License Number | PPNS00068 |
| License Number State | RI |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | R236222 |
| License Number State | MD |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | APRN04750 |
| License Number State | RI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: