Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0214X | Pediatric Pulmonologist | 257460 | MA |
Y | 2080P0214X | Pediatric Pulmonologist | MD12506 | RI |
NPI | 1497727101 |
---|---|
Provider Name | Karen Daigle |
First Address | Providence, RI 02903-4923 |
Second Address | Providence, RI 02903 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2006 |
Last Update Date | 23/04/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
KD68479 | (05) | RI |
MD12506 | LICENSE (01) | RI |