Individual
MRS. TARA MITCHELL MARTINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, RN, PMHNP-BC
Contact information
Practice address
194 WATERMAN ST, PROVIDENCE, RI 02906-4015
(401) 633-2929
Mailing address
194 WATERMAN ST, PROVIDENCE, RI 02906-4015
(401) 633-2929
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN2293881
MA
163W00000X
Registered Nurse
RN79538
RI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN04628
RI
Other
Enumeration date
08/14/2024
Last updated
09/25/2025
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