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Individual

MARY WHITTENHALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
375 WAMPANOAG TRL, SUITE 302B, RIVERSIDE, RI 02915-2232
(401) 649-4070
(401) 649-4071
Mailing address
DEPT 3010, PO BOX 986524, BOSTON, MA 02298-6524
(401) 443-4992
(401) 784-4902

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
APRN01320
RI
363LG0600X
Gerontology Nurse Practitioner
Primary
APRN01320
RI

Other

Enumeration date
10/23/2014
Last updated
06/17/2024
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