Healthcare Provider Details

I. General information

NPI: 1174455828
Provider Name (Legal Business Name): IVONNE CRISTINA ABAD BELTRAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 CLINTON ST
WOONSOCKET RI
02895-3207
US

IV. Provider business mailing address

183 COUNTY ST
FALL RIVER MA
02723-2103
US

V. Phone/Fax

Practice location:
  • Phone: 401-767-4100
  • Fax:
Mailing address:
  • Phone: 508-840-1006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0001294020
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: