Individual
KRISTIE MARIE MASSUCCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 EDDY ST, PROVIDENCE, RI 02905-4739
(401) 533-9100
(401) 533-9105
Mailing address
1000 EDDY ST, PROVIDENCE, RI 02905-4739
(401) 533-9100
(401) 533-9105
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
RN57382
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0614
NEIGHBORHOOD HEALTH
RI
05
—
ES01788
—
RI
01
—
SB870
BLUE CROSS
RI
Enumeration date
03/05/2019
Last updated
08/15/2019
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