Individual
PHINA A MAYU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1 RANDALL SQ, PROVIDENCE, RI 02904-2709
(401) 274-6339
(401) 453-6290
Mailing address
375 ALLENS AVE, PROVIDENCE, RI 02905-5010
(401) 444-0400
(401) 444-0468
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN01949
RI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
APRN01949
RI
Other
Enumeration date
10/31/2018
Last updated
02/16/2020
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