MEDICARE: KRISTEN ASHLEY RAU FNP-C

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
1	363LF0000X	Family Nurse Practitioner	RN2261863	MA
2	363LF0000X	Family Nurse Practitioner	RN53239	RI

General Provider Information

NPI Number	:	1558295766
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTEN ASHLEY RAU FNP-C

Provider Business Mailing Address
First Line	:	270 BLOOMFIELD ST
Second Line	:
City	:	PAWTUCKET
State	:	RI
Zip	:	02861-3432
Country	:	US
Telephone Number	:	508-840-4709
Fax Number	:

Provider Business Practice Location Address
First Line	:	270 BLOOMFIELD ST
Second Line	:
City	:	PAWTUCKET
State	:	RI
Zip	:	02861-3432
Country	:	US
Telephone Number	:	508-840-4709
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/11/2026
Last Update Date	:	06/11/2026

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