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Individual

CAROLYN A MCGILLIVRAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1377 S COUNTY TRL, SUITE 2B, EAST GREENWICH, RI 02818-5082
(401) 884-8900
(401) 884-9199
Mailing address
1377 S COUNTY TRL, SUITE 2B, EAST GREENWICH, RI 02818-5082
(401) 884-8900
(401) 884-9199

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NPP 16726
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000027423
BLUE CROSS/BLUE SHIELD
RI
01
408095
BLUE CHIP
RI
01
NPP16726
NURSEPRACTITIONER LICENSE
RI
Enumeration date
03/23/2006
Last updated
07/08/2007
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