Healthcare Provider Details

I. General information

NPI: 1346623691
Provider Name (Legal Business Name): STEPHANIE FORGET N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2015
Last Update Date: 11/19/2020
Certification Date: 11/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 VILLAGE PLAZA WAY
NORTH SCITUATE RI
02857-1849
US

IV. Provider business mailing address

PO BOX 312
PASCOAG RI
02859-0312
US

V. Phone/Fax

Practice location:
  • Phone: 401-647-6262
  • Fax: 401-647-6201
Mailing address:
  • Phone: 401-567-0800
  • Fax: 401-568-7949

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number339733
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: