Healthcare Provider Details

I. General information

NPI: 1720866643
Provider Name (Legal Business Name): KIMBERLY CURTIS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2023
Last Update Date: 09/04/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 BLACKSTONE STREET 2ND FLOOR
PROVIDENCE RI
02903
US

IV. Provider business mailing address

455 TOLL GATE ROAD PRC AND CREDENTIALING
WARWICK RI
02886-2759
US

V. Phone/Fax

Practice location:
  • Phone: 401-453-7520
  • Fax: 401-453-7529
Mailing address:
  • Phone: 401-273-0641
  • Fax: 401-273-2919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN05305
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: