Healthcare Provider Details

I. General information

NPI: 1598327603
Provider Name (Legal Business Name): SARAH GAMACHE NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2019
Last Update Date: 08/22/2023
Certification Date: 10/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

475 KILVERT ST
WARWICK RI
02886-1379
US

IV. Provider business mailing address

323 COVE AVE
WARWICK RI
02889-8610
US

V. Phone/Fax

Practice location:
  • Phone: 401-785-7753
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN02017
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN51219
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: