Doctor Name: | BEVERLY WALDMAN RICH |
NPI Number: | 1144250747 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN, BC |
License Number: | PPNS00013 |
Business Practice Address: | 1011 Veterans Memorial Pkwy East Providence, RI - 029155061 |
Business Phone Number: | 4014321022 |
Business Fax Number: | 4014321500 |
Mailing Address: | 593 Eddy St, Potter 3 PROVIDENCE |
State: | RI |
Postal Code: | 029034923 |
Phone Number: | 4014444318 |
Fax Number: | 4014446573 |
NPI Enumeration Date: | 07/03/2006 |
NPI Last Update Date: | 09/13/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 364SP0807X |
License Number: | PPNS00013 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | RI |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Clinical Nurse Specialist |
Taxonomy Specialization: | Psych/Mental Health, Child & Adolescent |
Taxonomy Definition: |