=====================================================
General NPI Number Information
=====================================================
NPI Number | 1881581148
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JENNIFER ROSE BADGER BSN, RN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/19/2025
-----------------------------------------------------
Last Update Date | 06/19/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 164 SUMMIT AVE
-----------------------------------------------------
City | PROVIDENCE
-----------------------------------------------------
State | RI
-----------------------------------------------------
Zip | 02906-2853
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 401-793-3004
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1005 VICTORY HWY APT A
-----------------------------------------------------
City | MAPLEVILLE
-----------------------------------------------------
State | RI
-----------------------------------------------------
Zip | 02839-1183
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-409-8131
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WE0003X
-----------------------------------------------------
Taxonomy Name | Emergency Registered Nurse
-----------------------------------------------------
License Number | RN66776
-----------------------------------------------------
License Number State | RI
-----------------------------------------------------