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General NPI Number Information
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NPI Number | 1598066615
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Entity Type | Individual
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Provider Name | KRISTEN E GRICUS PMHNP-BC, IBCLC
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Gender | Female
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Dates
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Enumeration Date | 11/05/2010
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Last Update Date | 12/23/2025
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Provider Practice Location Address
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Address Line | 65 VILLAGE SQUARE DR STE 302
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City | SOUTH KINGSTOWN
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State | RI
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Zip | 02879-2569
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Country | US
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Telephone | 844-754-6564
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Fax |
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Provider Business Mailing Address
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Address Line | 65 VILLAGE SQUARE DR STE 302
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City | SOUTH KINGSTOWN
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State | RI
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Zip | 02879-2569
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Country | US
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Telephone |
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN04914
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License Number State | RI
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