Individual
JUDITH SALOME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
530 N MAIN ST, PROVIDENCE, RI 02904-5762
(401) 415-8852
Mailing address
530 N MAIN ST, PROVIDENCE, RI 02904-5762
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
RN34399
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
163W00000X
—
RI
Enumeration date
11/19/2018
Last updated
11/19/2018
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