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General NPI Number Information
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NPI Number | 1871116996
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Entity Type | Individual
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Provider Name | MARISSA ELIZABETH SIMEONE CORDEIRO APRN-CNP
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Gender | Female
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Dates
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Enumeration Date | 05/22/2020
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 334 COUNTY RD STE D
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City | BARRINGTON
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State | RI
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Zip | 02806-2430
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Country | US
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Telephone | 401-247-2288
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Fax |
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Provider Business Mailing Address
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Address Line | 151 SUNRISE DR
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City | BRISTOL
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State | RI
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Zip | 02809-5023
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Country | US
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Telephone | 401-374-3184
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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 | APRN02287
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN52453
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License Number State | RI
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