Healthcare Provider Details

I. General information

NPI: 1831901172
Provider Name (Legal Business Name): JOSHUA GAUMOND FNP, DNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2025
Last Update Date: 01/23/2025
Certification Date: 01/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

481 KINGSTOWN RD
WAKEFIELD RI
02879-3626
US

IV. Provider business mailing address

108 CORNELL ST
CRANSTON RI
02920-4000
US

V. Phone/Fax

Practice location:
  • Phone: 401-789-0283
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN04438
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: