Healthcare Provider Details

I. General information

NPI: 1649036336
Provider Name (Legal Business Name): KELLY L POLLARD RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KELLY L SEARLE RN

II. Dates (important events)

Enumeration Date: 02/21/2024
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1268 EDDY ST
PROVIDENCE RI
02905-4535
US

IV. Provider business mailing address

137 DOUGLAS RD
WARWICK RI
02886-2732
US

V. Phone/Fax

Practice location:
  • Phone: 401-272-3018
  • Fax:
Mailing address:
  • Phone: 401-439-4392
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN43731
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: