Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | APRN02107 | RI |
NPI | 1093369936 |
---|---|
Provider Name | Mrs. Jacalyn Sue Finerty |
First Address | Providence, RI 02905-2401 |
Second Address | Providence, RI 02905-2499 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2019 |
Last Update Date | 26/12/2019 |