Healthcare Provider Details

I. General information

NPI: 1710687884
Provider Name (Legal Business Name): ISABELLE ETHEL OCHOLLA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/07/2023
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1130 TEN ROD RD STE F207C
NORTH KINGSTOWN RI
02852-4172
US

IV. Provider business mailing address

38 CEDAR LN
SEEKONK MA
02771-3241
US

V. Phone/Fax

Practice location:
  • Phone: 401-405-1839
  • Fax: 401-399-8932
Mailing address:
  • Phone: 774-297-8778
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2345589
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberCAPRN04364
License Number StateRI
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN2345589
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: