Healthcare Provider Details

I. General information

NPI: 1205351046
Provider Name (Legal Business Name): ANGELA MARIA ALLEN RN, CDOE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2017
Last Update Date: 08/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 JOHN H CHAFEE BLVD
NEWPORT RI
02840-1034
US

IV. Provider business mailing address

244 N FENNER AVE
MIDDLETOWN RI
02842-5432
US

V. Phone/Fax

Practice location:
  • Phone: 401-848-2160
  • Fax:
Mailing address:
  • Phone: 401-636-9806
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License NumberRN2458
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: