NPI Code Details Logo

NPI 1689201980

NPI 1689201980 : KATHERINE ELIZABETH BLISS APRN, FNP-C, PMHNP-C : PROVIDENCE, RI

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1689201980
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    KATHERINE ELIZABETH BLISS APRN, FNP-C, PMHNP-C
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    03/25/2020
-----------------------------------------------------
    Last Update Date     |    01/02/2026
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    331 BROADWAY STE 102 
-----------------------------------------------------
    City                 |    PROVIDENCE
-----------------------------------------------------
    State                |    RI
-----------------------------------------------------
    Zip                  |    02909-1101
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    401-206-0392
-----------------------------------------------------
    Fax                  |    774-209-4469
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    94 OVERLOOK DR 
-----------------------------------------------------
    City                 |    EAST GREENWICH
-----------------------------------------------------
    State                |    RI
-----------------------------------------------------
    Zip                  |    02818-4721
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    401-206-0392
-----------------------------------------------------
    Fax                  |    774-209-4469
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    363LP0808X
-----------------------------------------------------
    Taxonomy Name        |    Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
    License Number       |    APRN04737
-----------------------------------------------------
    License Number State |    RI
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    363L00000X
-----------------------------------------------------
    Taxonomy Name        |    Nurse Practitioner
-----------------------------------------------------
    License Number       |    APRN02304
-----------------------------------------------------
    License Number State |    RI
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.