| NPI | 1154060861 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH JEAN PINCINCE Administrator 401-770-3813 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 207Q00000X Family Medicine | |
| Enumeration Date | 2022-06-01 |
| Last Update Date | 2022-06-01 |