Individual
RAINIER JOSEPH PONCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSN, FNP-C
Contact information
Practice address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-5891
Mailing address
117 ELLENFIELD ST STE 101, PROVIDENCE, RI 02905-4541
(401) 444-6779
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN03026
RI
363L00000X
Nurse Practitioner
RN2338572
MA
363LF0000X
Family Nurse Practitioner
RN-TEMP14701
MA
Other
Enumeration date
03/10/2022
Last updated
06/03/2024
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