Healthcare Provider Details

I. General information

NPI: 1518242460
Provider Name (Legal Business Name): NANCY ADLER MOYE CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2011
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1052 PARK AVE
CRANSTON RI
02910-3225
US

IV. Provider business mailing address

1052 PARK AVE
CRANSTON RI
02910-3225
US

V. Phone/Fax

Practice location:
  • Phone: 401-461-5056
  • Fax: 401-942-3590
Mailing address:
  • Phone: 401-461-5056
  • Fax: 401-942-3590

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2328439
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN00181
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: