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NPI Code Detail

MEDICARE: MINDBRIDGE WELLNESS

MEDICARE: MINDBRIDGE WELLNESS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number : 1518759794
Entity Type Code : Organization
Provider Name (Legal Business Name) : MINDBRIDGE WELLNESS
Provider Business Mailing Address
First Line : 1276 BALD HILL RD UNIT 15 #1038
Second Line :
City : WARWICK
State : RI
Zip : 02886
Country : US
Telephone Number : 401-240-4796
Fax Number : 401-235-4088
Provider Business Practice Location Address
First Line : 66 MAIN ST STE 202
Second Line :
City : WAKEFIELD
State : RI
Zip : 02879-3651
Country : US
Telephone Number : 401-240-4796
Fax Number : 401-235-4088
Authorized Official
Title or Position : PSYCHIATRIC NURSE PRACTITIONER
Name : EURIDICE NOBRE
Credential : PMHNP
Telephone Number : 401-240-4796
Provider Enumeration Date : 05/21/2025
Last Update Date : 05/21/2025

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Directions to “MINDBRIDGE WELLNESS ” Practice Location

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