Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | APRN02214 | RI |
NPI | 1003452913 |
---|---|
Provider Name | Beverly Casinelli |
First Address | Providence, RI 02905-4541 |
Second Address | Providence, RI 02905-5443 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/11/2019 |
Last Update Date | 30/01/2020 |