Individual
TARA HANNAH SHOULDIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-4000
Mailing address
110 ELM ST, PROVIDENCE, RI 02903-4626
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
80652
RI
363LP0200X
Pediatric Nurse Practitioner
Primary
APRN04746
RI
Other
Enumeration date
05/13/2025
Last updated
08/12/2025
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