Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | NPP37339 | RI |
NPI | 1003869561 |
---|---|
Provider Name | Ms. Sarah L Congleton |
First Address | East Greenwich, RI 02818-5079 |
Second Address | East Greenwich, RI 02818-5079 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2006 |
Last Update Date | 05/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
Q62620 | (02) | RI |