Healthcare Provider Details

I. General information

NPI: 1447876206
Provider Name (Legal Business Name): CARINE MARIE SAINT FELIX APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2020
Last Update Date: 09/02/2021
Certification Date: 09/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 N MAIN STREET
PROVIDENCE RI
02904
US

IV. Provider business mailing address

530 N MAIN STREET
PROVIDENCE RI
02904
US

V. Phone/Fax

Practice location:
  • Phone: 401-528-0123
  • Fax: 401-528-0124
Mailing address:
  • Phone: 401-528-0123
  • Fax: 401-528-0124

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN02779
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: