MEDICARE: MS. ELIZABETH DA SILVA APRN

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
1	363LF0000X	Family Nurse Practitioner	APRN02191	RI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	15018818	OTHER		CAQH

General Provider Information

NPI Number	:	1982208484
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ELIZABETH DA SILVA APRN

Provider Business Mailing Address
First Line	:	1243 MINERAL SPRING AVE UNIT 7
Second Line	:
City	:	NORTH PROVIDENCE
State	:	RI
Zip	:	02904-4636
Country	:	US
Telephone Number	:	401-388-3899
Fax Number	:	401-340-1831

Provider Business Practice Location Address
First Line	:	1243 MINERAL SPRING AVE UNIT 7
Second Line	:
City	:	NORTH PROVIDENCE
State	:	RI
Zip	:	02904-4636
Country	:	US
Telephone Number	:	401-388-3899
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/24/2020
Last Update Date	:	01/02/2024

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