Individual provider Active NPI

Pamela L Vicente, CRNP

  • Women's Health Nurse Practitioner
  • Bethlehem, PA
National Provider Identifier
1891024899
Registry record updated Dec 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
SP001741G Issued in PA
Practice address
623 W Union Blvd
Suite 5
Bethlehem, PA 18018-3708
Phone
(610) 868-0104
Fax
(610) 868-0204
NPI assigned
Dec 22, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X SP001741G PA Primary

Addresses

Primary practice location

623 W Union Blvd
Suite 5
Bethlehem, PA 18018-3708

Mailing address

623 W Union Blvd
Suite 5
Bethlehem, PA 18018-3708
Phone (610) 868-0104

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SP001741GPAMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Echenberg Institute for Pelvic and Sexual Pain Past Accepting new patients
Robert J Echenberg MD Womens Health Pelvic Pain & Sexual Wellness PC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1261440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261440000000",
    "number": "1891024899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 W UNION BLVD",
            "address_2": "SUITE 5",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180183708",
            "telephone_number": "610-868-0104",
            "fax_number": "610-868-0204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 W UNION BLVD",
            "address_2": "SUITE 5",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180183708",
            "telephone_number": "610-868-0104",
            "fax_number": "610-868-0204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICENTE",
        "first_name": "PAMELA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-22",
        "last_updated": "2009-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "PA",
            "license": "SP001741G",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethlehem, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.