Healthcare Provider Details

I. General information

NPI: 1003086208
Provider Name (Legal Business Name): JEANNE M VERITY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/04/2008
Last Update Date: 03/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1126 HARTFORD AVE
JOHNSTON RI
02919-7109
US

IV. Provider business mailing address

10 FAIRMOUNT ST
SMITHFIELD RI
02917-3007
US

V. Phone/Fax

Practice location:
  • Phone: 401-519-1940
  • Fax:
Mailing address:
  • Phone: 401-231-0833
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number24205
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: