Healthcare Provider Details

I. General information

NPI: 1538492525
Provider Name (Legal Business Name): PATRICIA L GIARRUSSO PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2009
Last Update Date: 07/13/2023
Certification Date: 07/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1126 HARTFORD AVE
JOHNSTON RI
02919-7109
US

IV. Provider business mailing address

7777 FOREST LN C 833
DALLAS TX
75230-2505
US

V. Phone/Fax

Practice location:
  • Phone: 401-351-2750
  • Fax: 13-516-6134
Mailing address:
  • Phone: 972-566-4591
  • Fax: 972-566-6679

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN01699
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License Number768894
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: