Individual
JENNIFER DEROSSI-DACOSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN,CDE,CDOE
Contact information
Practice address
111 BREWSTER STREET, CNEMG PRIMARY CARE AND SPECIALTY SERVICES, PAWTUCKET, RI 02860-4474
(401) 729-2238
(401) 729-2923
Mailing address
455 TOLL GATE RD, WARWICK, RI 02886-2759
(401) 273-0641
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
RN51935
RI
174H00000X
Health Educator
RN51935
RI
Other
Enumeration date
10/14/2015
Last updated
01/22/2020
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