Healthcare Provider Details

I. General information

NPI: 1902733439
Provider Name (Legal Business Name): MARIANA RESTREPO ZAPATA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

148 W RIVER ST
PROVIDENCE RI
02904-2615
US

IV. Provider business mailing address

148 W RIVER ST
PROVIDENCE RI
02904-2615
US

V. Phone/Fax

Practice location:
  • Phone: 401-421-6306
  • Fax:
Mailing address:
  • Phone: 401-421-6306
  • Fax: 401-453-0330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberRN62437
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: