Healthcare Provider Details

I. General information

NPI: 1710688577
Provider Name (Legal Business Name): JAMES W JEWETT RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2023
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 NATE WHIPPLE HWY STE 202
CUMBERLAND RI
02864-1423
US

IV. Provider business mailing address

175 NATE WHIPPLE HWY STE 202
CUMBERLAND RI
02864-1423
US

V. Phone/Fax

Practice location:
  • Phone: 617-767-7878
  • Fax:
Mailing address:
  • Phone: 617-767-7878
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN64824
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN03893
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: