Pamela Dhillon, APRN
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Niantic, CT
NPI 1093094401 · NPPES record last updated Aug 16, 2011
Key facts
- NPI
- 1093094401
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 004561 (CT)
- Practice address
- 215 West Main St
Niantic, CT 06357 - Phone
- (860) 691-6959
- NPI assigned
- Aug 16, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004561 | CT | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mystic Bridge to Wellness, LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 004561 | CT | Yes |
Addresses
Primary practice location
215 West Main St
Niantic, CT 06357
Mailing address
215 West Main St
Niantic, CT 06357
Phone (860) 691-6959
Other providers in Niantic, CT
- Martin Dacunha
- Nicole Danish
- Agnes Z. Dardas
- David D Thompson Jr & Robert a Linden PTR
- Detox Virtually
- Tracey Dineen-Hutchins
- Brittany Dolce
- Penelope Ann Donahue
- Abel A Donka
- Dr Jillian Bradley LLC
All providers in Niantic, CT · Psychiatric/Mental Health Nurse Practitioner in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 16, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.