Healthcare Provider Details

I. General information

NPI: 1801954847
Provider Name (Legal Business Name): TERRI BELANGER PCNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 08/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 BLACKSTONE BLVD ANNEX BLDG, RM 232
PROVIDENCE RI
02906-4800
US

IV. Provider business mailing address

48 TURNER DR
WEST WARWICK RI
02893-5428
US

V. Phone/Fax

Practice location:
  • Phone: 800-370-3651
  • Fax:
Mailing address:
  • Phone: 401-331-1350
  • Fax: 401-277-3366

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberPPNS00063
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN25557
License Number StateRI
# 3
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberPPNS00063
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: