Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | NPP37607 | RI |
N | 363LA2100X | Nurse Practitioner - Acute Care | 003874 | CT |
N | 363LA2100X | Nurse Practitioner - Acute Care | NPP37607 | RI |
NPI | 1023267580 |
---|---|
Provider Name | Mrs. Elizabeth Anne Hart |
First Address | Wakefield, RI 02880-0229 |
Second Address | Wakefield, RI 02879-4216 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/09/2008 |
Last Update Date | 24/11/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
EH86374 | (05) | RI |