Individual
THEODORE STANTON KAISER III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN, CDOE
Contact information
Practice address
530 N MAIN ST, PROVIDENCE, RI 02904-5762
(401) 415-9500
(401) 415-9515
Mailing address
375 ALLENS AVE, PROVIDENCE, RI 02905-5010
(401) 444-0400
(401) 444-0468
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
32575
RI
163WD0400X
Diabetes Educator Registered Nurse
Primary
RN32575
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
163W00000X
—
RI
Enumeration date
08/11/2015
Last updated
07/21/2022
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