Healthcare Provider Details

I. General information

NPI: 1790326023
Provider Name (Legal Business Name): EMILY SARAH ADAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2019
Last Update Date: 10/25/2021
Certification Date: 10/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 CENTRAL ST
PROVIDENCE RI
02907-2201
US

IV. Provider business mailing address

65 WALNUT ST STE 310
WELLESLEY MA
02481-2129
US

V. Phone/Fax

Practice location:
  • Phone: 401-648-4700
  • Fax:
Mailing address:
  • Phone: 781-772-1527
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number02216
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number2320455
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number2320455
License Number StateMA
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number61201
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: