Healthcare Provider Details

I. General information

NPI: 1013789759
Provider Name (Legal Business Name): ROBERT D WHITFORD RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2023
Last Update Date: 10/26/2023
Certification Date: 10/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 JOHNNY CAKE HILL RD
MIDDLETOWN RI
02842-5674
US

IV. Provider business mailing address

127 JOHNNY CAKE HILL RD
MIDDLETOWN RI
02842-5674
US

V. Phone/Fax

Practice location:
  • Phone: 401-843-1213
  • Fax: 401-848-6398
Mailing address:
  • Phone: 401-843-1213
  • Fax: 401-848-6398

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN55758
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: