Organization
PETITPAS PSYCHIATRIC SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PATRICIA A PETITPAS APRN/PCNS (OWNER)
(401) 944-0194
Entity
Organization
Contact information
Practice address
900 RESERVOIR AVE, STE.2, CRANSTON, RI 02910-4453
(401) 944-0194
(401) 944-0196
Mailing address
900 RESERVOIR AVE, STE.2, CRANSTON, RI 02910-4453
(401) 944-0194
(401) 944-0196
Taxonomy
Speciality
Code
Description
License number
State
364SP0809X
Adult Psychiatric/Mental Health Clinical Nurse Specialist
Primary
PCNS00064
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000032309
RI BLUE CROSS PROVIDER #
RI
01
—
413965
RI BLUE CHIP PROVIDER #
RI
01
—
6228710
UNITED HEALTH PROVIDER #
RI
Enumeration date
12/22/2015
Last updated
12/22/2015
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