Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | APRN01474 | RI |
NPI | 1043752538 |
---|---|
Provider Name | Sherry Demacedo |
First Address | Providence, RI 02906-2853 |
Second Address | Providence, RI 02906-2853 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2016 |
Last Update Date | 15/11/2016 |