Healthcare Provider Details

I. General information

NPI: 1073555645
Provider Name (Legal Business Name): DAWN M CATER NPP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 06/21/2023
Certification Date: 06/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1139 MAIN AVE GENESIS HEALTH CARE GREENWOOD CENTER
WARWICK RI
02886-1940
US

IV. Provider business mailing address

1139 MAIN AVE GENESIS HEALTH CARE GREENWOOD CENTER
WARWICK RI
02886-1940
US

V. Phone/Fax

Practice location:
  • Phone: 401-739-6600
  • Fax: 401-738-0310
Mailing address:
  • Phone: 401-739-6600
  • Fax: 401-738-0310

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QB0002X
TaxonomyObesity Medicine (Family Medicine) Physician
License Number00416
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number00416
License Number StateRI
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number00416
License Number StateRI
# 4
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN00416
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: