Healthcare Provider Details

I. General information

NPI: 1972427169
Provider Name (Legal Business Name): TERRYN PATRICIA BORKMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2026
Last Update Date: 08/08/2026
Certification Date: 08/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 S BLOSSOM ST
EAST PROVIDENCE RI
02914-2905
US

IV. Provider business mailing address

106 S BLOSSOM ST
EAST PROVIDENCE RI
02914-2905
US

V. Phone/Fax

Practice location:
  • Phone: 508-493-6603
  • Fax:
Mailing address:
  • Phone: 508-493-6603
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2317724
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: