Individual
JENUS P HIATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN,CDOE
Contact information
Practice address
21 PEACE ST, PROVIDENCE, RI 02907-1510
(401) 456-4325
(401) 456-4250
Mailing address
75 PINE HILL RD, JOHNSTON, RI 02919-2891
(401) 439-4783
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
RN29086
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
29086
RN LICENSE
RI
Enumeration date
05/17/2011
Last updated
05/17/2011
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