Healthcare Provider Details

I. General information

NPI: 1891920401
Provider Name (Legal Business Name): BOBETTE S CHASE RN, CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2009
Last Update Date: 05/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66 DIAMOND HILL RD
WARWICK RI
02886-6706
US

IV. Provider business mailing address

66 DIAMOND HILL RD
WARWICK RI
02886-6706
US

V. Phone/Fax

Practice location:
  • Phone: 401-569-0590
  • Fax:
Mailing address:
  • Phone: 401-569-0590
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License NumberRN27078
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: