Healthcare Provider Details

I. General information

NPI: 1497901961
Provider Name (Legal Business Name): ALLISON KENYON TROMBLY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. ALLISON LEE KENYON

II. Dates (important events)

Enumeration Date: 08/14/2008
Last Update Date: 08/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1035 POST RD
WARWICK RI
02888-3363
US

IV. Provider business mailing address

17 VIRGINIA AVE SUITE 107
PROVIDENCE RI
02905-4406
US

V. Phone/Fax

Practice location:
  • Phone: 401-941-2830
  • Fax: 401-941-6886
Mailing address:
  • Phone: 401-784-4923
  • Fax: 401-784-4902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number003848
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNPP37559
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: