Healthcare Provider Details

I. General information

NPI: 1063417855
Provider Name (Legal Business Name): JANICE ELENA ARCHER AP RN CS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2005
Last Update Date: 02/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 MERRYMOUNT DR
WARWICK RI
02888-5525
US

IV. Provider business mailing address

60 MERRYMOUNT DR
WARWICK RI
02888-5525
US

V. Phone/Fax

Practice location:
  • Phone: 401-463-7521
  • Fax:
Mailing address:
  • Phone: 401-463-7521
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberCAPRN00923
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: