Individual
VIRGINIA L PAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, CDOE
Contact information
Practice address
900 WARREN AVE STE 100, EAST PROVIDENCE, RI 02914-1430
(401) 383-9662
(401) 383-6526
Mailing address
163 GOLD MINE RD, CHEPACHET, RI 02814-1758
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
RN18730
RI
163W00000X
Registered Nurse
RN18730
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1063760130
NPI
RI
Enumeration date
08/21/2012
Last updated
09/21/2017
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