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General NPI Number Information
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NPI Number | 1487273363
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Entity Type | Individual
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Provider Name | ROSE TILUS FNP
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Gender | Female
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Dates
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Enumeration Date | 04/10/2020
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Last Update Date | 07/13/2023
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Provider Practice Location Address
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Address Line | 1126 HARTFORD AVE
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City | JOHNSTON
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State | RI
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Zip | 02919-7109
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Country | US
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Telephone | 401-519-1902
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Fax |
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Provider Business Mailing Address
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Address Line | 129 SAMUEL AVE
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City | PAWTUCKET
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State | RI
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Zip | 02860-1623
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Country | US
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Telephone | 401-632-9297
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN02317
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License Number State | RI
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