Healthcare Provider Details

I. General information

NPI: 1063608982
Provider Name (Legal Business Name): JAMES PATRICK MERCHANT RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2007
Last Update Date: 09/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 VALLEY RD
MIDDLETOWN RI
02842-5234
US

IV. Provider business mailing address

3 S CREST ST
MIDDLETOWN RI
02842-6039
US

V. Phone/Fax

Practice location:
  • Phone: 401-846-6620
  • Fax:
Mailing address:
  • Phone: 401-662-9911
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN42098
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number274754
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: