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General NPI Number Information
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NPI Number | 1770232969
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Entity Type | Individual
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Provider Name | JESSICA BRAGA RN
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Gender | Female
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Dates
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Enumeration Date | 03/23/2022
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Last Update Date | 03/23/2022
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Provider Practice Location Address
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Address Line | 1443 HARTFORD AVE
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City | JOHNSTON
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State | RI
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Zip | 02919-3224
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Country | US
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Telephone | 401-273-8100
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Fax | 401-553-1072
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Provider Business Mailing Address
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Address Line | 15 FALL RIVER AVE
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City | SEEKONK
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State | MA
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Zip | 02771-5323
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Country | US
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Telephone | 401-374-2430
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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 | 163WP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Registered Nurse
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License Number | RN5889
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License Number State | RI
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