Healthcare Provider Details

I. General information

NPI: 1831365659
Provider Name (Legal Business Name): PEGGY M ROYE NPP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2008
Last Update Date: 08/24/2020
Certification Date: 08/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

593 EDDY ST CLAVERICK 2
PROVIDENCE RI
02903-4923
US

IV. Provider business mailing address

125 WHIPPLE ST STE 3
PROVIDENCE RI
02908-3258
US

V. Phone/Fax

Practice location:
  • Phone: 401-519-1604
  • Fax: 401-272-0538
Mailing address:
  • Phone: 401-519-0330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP37464
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberNPP37464
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: