Healthcare Provider Details

I. General information

NPI: 1558295766
Provider Name (Legal Business Name): KRISTEN ASHLEY RAU FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 VETERANS MEMORIAL PKWY # 15B
EAST PROVIDENCE RI
02914-5300
US

IV. Provider business mailing address

270 BLOOMFIELD ST
PAWTUCKET RI
02861-3432
US

V. Phone/Fax

Practice location:
  • Phone: 401-434-3350
  • Fax: 401-434-5230
Mailing address:
  • Phone: 508-840-4709
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN05368
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2261863
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: