MEDICARE: ALLISON ROSE TASKIN AGACNP-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
1	363LA2100X	Acute Care Nurse Practitioner	APRN02517	RI

General Provider Information

NPI Number	:	1730785189
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLISON ROSE TASKIN AGACNP-BC

Provider Business Mailing Address
First Line	:	16 PINE GROVE AVE
Second Line	:
City	:	LINCOLN
State	:	RI
Zip	:	02865-3615
Country	:	US
Telephone Number	:	401-474-7724
Fax Number	:

Provider Business Practice Location Address
First Line	:	16 PINE GROVE AVE
Second Line	:
City	:	LINCOLN
State	:	RI
Zip	:	02865-3615
Country	:	US
Telephone Number	:	401-474-7724
Fax Number	:

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

Provider Enumeration Date	:	12/10/2020
Last Update Date	:	03/17/2026

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