Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 163W00000X | Registered Nurse | | RN23411 | RHODE ISLAND | No |
| 2 | 364S00000X | Clinical Nurse Specialist | | PNS00015 | RHODE ISLAND | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | DB35712 | OTHER | RHODE ISLAND | MEDICAID RITE SHARE OF RI |
| 2 | S65957 | MEDICARE UPIN | | |
| 3 | 223229 | OTHER | RHODE ISLAND | BCBS OF RI |
| 4 | 1021340 | OTHER | RHODE ISLAND | NEIGHBORHOOD HLTH PLAN RI |
| 5 | 349426 | OTHER | MASSACHUSETTS | BCBS OF MA |
| 6 | 408600 | OTHER | RHODE ISLAND | BLUE CHIP OF RI |
| 7 | 6265640 | OTHER | | UNITED HLTH OF NE |
| 8 | 463957 | OTHER | | TUFTS HLTH PLAN |
| 9 | 899022322 | MEDICARE ID-TYPE UNSPECIFIED | RHODE ISLAND | |
