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Individual

MICHAELA ANN MAYNARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
1125 N MAIN ST, PROVIDENCE, RI 02904-5739
(401) 793-2928
Mailing address
1125 N MAIN ST, PROVIDENCE, RI 02904-5739
(401) 793-2928

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
CAPRN01596
RI
363LA2200X
Adult Health Nurse Practitioner
RN2302797
MA

Other

Enumeration date
08/04/2015
Last updated
11/27/2019
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