Healthcare Provider Details

I. General information

NPI: 1356255087
Provider Name (Legal Business Name): KRISTEN ROSE THURBER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 COLLYER ST STE 201
PROVIDENCE RI
02904-1869
US

IV. Provider business mailing address

15 LA SALLE SQ
PROVIDENCE RI
02903-1814
US

V. Phone/Fax

Practice location:
  • Phone: 401-272-7799
  • Fax: 401-453-9078
Mailing address:
  • Phone: 401-444-6779
  • Fax: 401-444-6912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN70232
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: