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Individual

KATHLEEN HENDERSHOT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
4705 OLD POST RD UNIT A, CHARLESTOWN, RI 02813-1842
(401) 364-7705
(401) 364-3310
Mailing address
PO BOX 899, CHARLESTOWN, RI 02813-0899
(401) 364-7705
(401) 364-9104

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN32023
RI
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
RN32023
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
KM55734
RI
Enumeration date
03/09/2007
Last updated
05/23/2016
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