Healthcare Provider Details

I. General information

NPI: 1407741366
Provider Name (Legal Business Name): NANCY A ESCOBAR CD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2025
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 MAYFLOWER ST
EAST PROVIDENCE RI
02914-1413
US

IV. Provider business mailing address

24 MAYFLOWER ST
EAST PROVIDENCE RI
02914-1413
US

V. Phone/Fax

Practice location:
  • Phone: 401-248-3335
  • Fax:
Mailing address:
  • Phone: 401-248-3335
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number7187
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: