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General NPI Number Information
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NPI Number | 1801754999
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Entity Type | Organization
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Legal Business Name | GRACEFUL INNER LIGHT, LLC
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Dates
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Enumeration Date | 01/15/2026
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Last Update Date | 01/15/2026
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Provider Practice Location Address
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Address Line | 1200 HARTFORD AVE UNIT 105
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City | JOHNSTON
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State | RI
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Zip | 02919-7141
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Country | US
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Telephone | 401-742-7037
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Fax |
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Provider Business Mailing Address
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Address Line | 33 BRANDON RD
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City | CRANSTON
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State | RI
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Zip | 02910-1207
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Country | US
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Telephone | 401-742-1192
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LINDA VASQUEZ
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Credential | FNP-BC
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Telephone | 401-742-7037
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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 |
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License Number State |
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