Individual
JELISSA NEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHNP-BC
Contact information
Practice address
175 BROAD ST, PROVIDENCE, RI 02903-4026
(401) 421-9620
Mailing address
175 BROAD ST, PROVIDENCE, RI 02903-4026
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
APRN03629
RI
363LW0102X
Women's Health Nurse Practitioner
RN10024461
MA
Other
Enumeration date
06/09/2023
Last updated
06/04/2025
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