Healthcare Provider Details

I. General information

NPI: 1659202349
Provider Name (Legal Business Name): HANNAH R SMALL RN, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 EDDY ST
PROVIDENCE RI
02903-4202
US

IV. Provider business mailing address

350 EDDY ST
PROVIDENCE RI
02903-4202
US

V. Phone/Fax

Practice location:
  • Phone: 401-874-9711
  • Fax: 401-874-9050
Mailing address:
  • Phone: 401-874-9711
  • Fax: 401-874-9050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN10020097
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN79625
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: