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NPI Code Detail

MEDICARE: CHRISTINE MORICONI PMHNP-BC

MEDICARE: CHRISTINE MORICONI PMHNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorRN203210LPA
2163WP0808XPsychiatric/Mental Health Registered NurseAPRN02085RI

General Provider Information

NPI Number : 1164452447
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINE MORICONI PMHNP-BC
Provider Business Mailing Address
First Line : 1 RIVER ST
Second Line :
City : WAKEFIELD
State : RI
Zip : 02879-3214
Country : US
Telephone Number : 401-783-0523
Fax Number : 401-783-9448
Provider Business Practice Location Address
First Line : 1 RIVER ST
Second Line :
City : WAKEFIELD
State : RI
Zip : 02879-3214
Country : US
Telephone Number : 401-783-0523
Fax Number : 401-783-9448
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2006
Last Update Date : 08/28/2019

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Directions to “ CHRISTINE MORICONI PMHNP-BC” Practice Location

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