Healthcare Provider Details

I. General information

NPI: 1144749649
Provider Name (Legal Business Name): NINA MONEYMAKER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NINA BARTO

II. Dates (important events)

Enumeration Date: 09/15/2017
Last Update Date: 08/07/2024
Certification Date: 08/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 PLAIN ST
PROVIDENCE RI
02903-4828
US

IV. Provider business mailing address

101 PLAIN ST
PROVIDENCE RI
02903-4828
US

V. Phone/Fax

Practice location:
  • Phone: 401-453-7560
  • Fax: 401-453-7573
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number0024175289
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAPRN03767
License Number StateRI
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0001194191
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: