Healthcare Provider Details

I. General information

NPI: 1649662511
Provider Name (Legal Business Name): EMILY BETH HO RNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMILY BETH BALCHUNAS RNP

II. Dates (important events)

Enumeration Date: 03/02/2015
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

375 WAMPANOAG TRL STE 302B
RIVERSIDE RI
02915-2235
US

IV. Provider business mailing address

110 ELM ST STE 2
PROVIDENCE RI
02903-4626
US

V. Phone/Fax

Practice location:
  • Phone: 401-649-4070
  • Fax: 401-649-4071
Mailing address:
  • Phone: 401-784-0401
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberCAPRN01210
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberCAPRN01210
License Number StateRI
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN01210
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: