Organization
ME RHODE ISLAND LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE JACKSON (OWNER)
(401) 226-7032
Entity
Organization
Contact information
Practice address
31 GREENLAKE DR, GREENVILLE, RI 02828-3101
(401) 226-7032
Mailing address
31 GREENLAKE DR, GREENVILLE, RI 02828-3101
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/15/2024
Last updated
10/15/2024
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