Individual
TENESHA R LISBON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
355 PRAIRIE AVE, PROVIDENCE, RI 02905
(401) 444-0570
(401) 444-0427
Mailing address
375 ALLENS AVE, PROVIDENCE, RI 02905-5010
(401) 444-0400
(401) 444-0468
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN01828
RI
363LP2300X
Primary Care Nurse Practitioner
RN2275245
MA
Other
Enumeration date
10/29/2013
Last updated
04/15/2021
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