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NPI Code Detail

MEDICARE: KATELYN RUTH PEARSON

MEDICARE: KATELYN RUTH PEARSON
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
1104100000XSocial Worker
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1548629058
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATELYN RUTH PEARSON
Provider Business Mailing Address
First Line : 513 BROADWAY
Second Line :
City : NEWPORT
State : RI
Zip : 02840-1471
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 513 BROADWAY
Second Line :
City : NEWPORT
State : RI
Zip : 02840-1471
Country : US
Telephone Number : 401-324-9100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2016
Last Update Date : 03/13/2025

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Directions to “ KATELYN RUTH PEARSON ” Practice Location

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