Healthcare Provider Details

I. General information

NPI: 1720065337
Provider Name (Legal Business Name): ELIZABETH ANN VOLLUCCI R.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 12/23/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

390 TOLL GATE RD SUITE 201
WARWICK RI
02886-4326
US

IV. Provider business mailing address

124 BATES TRL
WEST GREENWICH RI
02817-2554
US

V. Phone/Fax

Practice location:
  • Phone: 401-738-8800
  • Fax: 401-738-7670
Mailing address:
  • Phone: 401-397-5101
  • Fax: 401-385-9260

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNPP37118
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: