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General NPI Number Information
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NPI Number | 1205145240
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Entity Type | Individual
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Provider Name | SARAH ROSE M LAMPORT NP
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Gender | Female
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Dates
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Enumeration Date | 09/24/2010
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Last Update Date | 02/25/2019
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Provider Practice Location Address
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Address Line | 375 WAMPANOAG TRL SUITE 102
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City | RIVERSIDE
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State | RI
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Zip | 02915-2212
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Country | US
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Telephone | 401-649-4010
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Fax | 401-649-4011
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Provider Business Mailing Address
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Address Line | 117 ELLENFIELD ST STE 101
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City | PROVIDENCE
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State | RI
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Zip | 02905-4513
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Country | US
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Telephone | 401-444-6779
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Fax | 401-444-6912
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN01180
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License Number State | RI
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