Individual
NICKOLAS DESOUSA FITZGERALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CCHW
Contact information
Practice address
823 MAIN ST, HOPE VALLEY, RI 02832-1920
(401) 539-2461
Mailing address
23 SPENCER DR, WESTERLY, RI 02891-1289
(774) 328-2195
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
200840
RI
Other
Enumeration date
05/21/2025
Last updated
05/23/2025
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