Healthcare Provider Details

I. General information

NPI: 1881894996
Provider Name (Legal Business Name): SONJA MOWATT RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2007
Last Update Date: 07/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 CUMMINGS WAY
WOONSOCKET RI
02895-3247
US

IV. Provider business mailing address

3 TANGLEWOOD DR
GREENVILLE RI
02828-1607
US

V. Phone/Fax

Practice location:
  • Phone: 401-235-7000
  • Fax:
Mailing address:
  • Phone: 401-949-0773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN36252
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: