MEDICARE: ABIGAIL PATRICIA WETZEL FNP-C, CNM

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	367A00000X	Advanced Practice Midwife	CNM00164	RI
2	363LF0000X	Family Nurse Practitioner	APRN01617	RI

General Provider Information

NPI Number	:	1972032530
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABIGAIL PATRICIA WETZEL FNP-C, CNM

Provider Business Mailing Address
First Line	:	21 DIVISION ST
Second Line	:
City	:	PAWTUCKET
State	:	RI
Zip	:	02860-5352
Country	:	US
Telephone Number	:	401-727-4800
Fax Number	:	401-726-1514

Provider Business Practice Location Address
First Line	:	21 DIVISION ST
Second Line	:
City	:	PAWTUCKET
State	:	RI
Zip	:	02860
Country	:	US
Telephone Number	:	401-727-4800
Fax Number	:	401-726-1514

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

Provider Enumeration Date	:	06/07/2017
Last Update Date	:	05/14/2026

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