Healthcare Provider Details

I. General information

NPI: 1326333816
Provider Name (Legal Business Name): JOYCE MARIE MACINTYRE RN CDOE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2011
Last Update Date: 06/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 WAKE ROBIN RD UNIT 310
LINCOLN RI
02865-5208
US

IV. Provider business mailing address

7 WAKE ROBIN RD UNIT 310
LINCOLN RI
02865-5208
US

V. Phone/Fax

Practice location:
  • Phone: 401-753-7965
  • Fax:
Mailing address:
  • Phone: 401-753-7965
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number32430
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: