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Individual

MODUPE O WILLIAMS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP-BC

Contact information

Practice address
1 KRISTEN DR, NORTH PROVIDENCE, RI 02911-2932
(401) 447-8569
Mailing address
1 KRISTEN DR, NORTH PROVIDENCE, RI 02911-2932

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN2319054
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
12345676289
MA
05
12345676289
RI
Enumeration date
10/23/2017
Last updated
10/23/2017
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