Healthcare Provider Details

I. General information

NPI: 1467034710
Provider Name (Legal Business Name): CYNTHIA LYNNE NOTARIANNI APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2021
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 NORTH RD STE A36
SOUTH KINGSTOWN RI
02879-2176
US

IV. Provider business mailing address

2 WINGATE RD
WAKEFIELD RI
02879-7697
US

V. Phone/Fax

Practice location:
  • Phone: 401-864-2447
  • Fax:
Mailing address:
  • Phone: 401-864-2447
  • Fax: 401-308-4480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN02662
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: