Healthcare Provider Details

I. General information

NPI: 1902724917
Provider Name (Legal Business Name): DANIELLA MARIE SMITH RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 BLACKSTONE BLVD STE 2
PROVIDENCE RI
02906-4829
US

IV. Provider business mailing address

21 MANVILLE HILL RD
CUMBERLAND RI
02864-2317
US

V. Phone/Fax

Practice location:
  • Phone: 401-455-6589
  • Fax:
Mailing address:
  • Phone: 401-455-6589
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number62454
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: