Individual
JILLIAN L. DEGRAIDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
725 RESERVOIR AVE, CRANSTON, RI 02910-4448
(401) 829-4446
Mailing address
725 RESERVOIR AVE, CRANSTON, RI 02910-4448
(401) 829-4446
(401) 829-4434
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
APRN03876
RI
363LG0600X
Gerontology Nurse Practitioner
APRN03876
RI
363LP2300X
Primary Care Nurse Practitioner
Primary
APRN03876
RI
Other
Enumeration date
12/05/2023
Last updated
12/22/2023
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