Healthcare Provider Details

I. General information

NPI: 1528268661
Provider Name (Legal Business Name): JAMIE LINDE ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2007
Last Update Date: 10/25/2023
Certification Date: 10/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 PONTIAC AVE
CRANSTON RI
02920-4460
US

IV. Provider business mailing address

PO BOX 437
NORTH EASTON MA
02356-0437
US

V. Phone/Fax

Practice location:
  • Phone: 401-468-3323
  • Fax:
Mailing address:
  • Phone: 401-468-3323
  • Fax: 401-468-3255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number01613
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number283061
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number01613
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: