Individual
KATHLEEN FAVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP-BC
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN34380
RI
363LA2100X
Acute Care Nurse Practitioner
Primary
NPP37680
RI
Other
Enumeration date
01/26/2012
Last updated
12/05/2018
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