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Individual

TRACEY MACDONALD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
R.N.

Contact information

Practice address
1443 HARTFORD AVE, JOHNSTON, RI 02919-3224
(401) 273-8100
(401) 861-8696
Mailing address
117 ELLENFIELD ST STE 101, PROVIDENCE, RI 02905-4513
(401) 444-6779
(401) 444-6912

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN50941
RI

Other

Enumeration date
05/11/2017
Last updated
11/03/2018
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