Healthcare Provider Details

I. General information

NPI: 1952170367
Provider Name (Legal Business Name): EURIDICE NOBRE PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2023
Last Update Date: 01/15/2025
Certification Date: 01/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

652 GEORGE WASHINGTON HWY UNIT 400
LINCOLN RI
02865-4267
US

IV. Provider business mailing address

652 GEORGE WASHINGTON HWY UNIT 400
LINCOLN RI
02865-4267
US

V. Phone/Fax

Practice location:
  • Phone: 401-334-1830
  • Fax: 401-334-1833
Mailing address:
  • Phone: 401-334-1830
  • Fax: 401-334-1833

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN03950
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberAPRN03950
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: