Healthcare Provider Details

I. General information

NPI: 1982918298
Provider Name (Legal Business Name): VIRGINA SILVA FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2010
Last Update Date: 07/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CVS DR MINUTECLINIC CREDENTIALING 2100
WOONSOCKET RI
02895-6146
US

IV. Provider business mailing address

32 COUNTRY WAY
MARSHFIELD MA
02050-6740
US

V. Phone/Fax

Practice location:
  • Phone: 401-770-1707
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number110814
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: