Healthcare Provider Details

I. General information

NPI: 1083177810
Provider Name (Legal Business Name): JENNIFER NITANYA BARLOW FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2019
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 JEFFERSON BLVD STE 5
WARWICK RI
02888-3878
US

IV. Provider business mailing address

155 JEFFERSON BLVD
WARWICK RI
02888-3852
US

V. Phone/Fax

Practice location:
  • Phone: 401-324-2232
  • Fax: 401-340-1830
Mailing address:
  • Phone: 401-324-2232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN02033
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: