Healthcare Provider Details

I. General information

NPI: 1609873843
Provider Name (Legal Business Name): KATHRYN N. WESTALL RNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2005
Last Update Date: 11/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 SOUTHWEST AVE
JAMESTOWN RI
02835-1120
US

IV. Provider business mailing address

20 SOUTHWEST AVE
JAMESTOWN RI
02835-1120
US

V. Phone/Fax

Practice location:
  • Phone: 401-423-2616
  • Fax: 401-423-3485
Mailing address:
  • Phone: 401-423-2616
  • Fax: 401-423-3485

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNPP17587
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: