Healthcare Provider Details

I. General information

NPI: 1174443022
Provider Name (Legal Business Name): ELIZABETH ROUND APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3461 S COUNTY TRL STE 301
EAST GREENWICH RI
02818-1463
US

IV. Provider business mailing address

PO BOX 229
WAKEFIELD RI
02880-0229
US

V. Phone/Fax

Practice location:
  • Phone: 401-471-6760
  • Fax:
Mailing address:
  • Phone: 401-788-3929
  • Fax: 401-788-3939

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN05341
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: