Healthcare Provider Details

I. General information

NPI: 1073433611
Provider Name (Legal Business Name): LAURA KING JONES RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1775 BALD HILL RD
WARWICK RI
02886-4231
US

IV. Provider business mailing address

22 WILLIAMS AVE
CRANSTON RI
02905-3414
US

V. Phone/Fax

Practice location:
  • Phone: 401-396-9331
  • Fax:
Mailing address:
  • Phone: 401-302-2538
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number86478265
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: