Healthcare Provider Details

I. General information

NPI: 1073110714
Provider Name (Legal Business Name): KATHLEEN PATRICIA NATARENO APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2020
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 PUTNAM PIKE
SMITHFIELD RI
02917-2408
US

IV. Provider business mailing address

400 PUTNAM PIKE
SMITHFIELD RI
02917-2408
US

V. Phone/Fax

Practice location:
  • Phone: 401-757-6160
  • Fax: 401-349-0840
Mailing address:
  • Phone: 401-757-6160
  • Fax: 401-349-0840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN02476
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: