Individual
MASON JAMES PROVOYEUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
528 N MAIN ST, PROVIDENCE, RI 02904-5770
(401) 276-4020
Mailing address
91 MARSHALL CIR, COVENTRY, RI 02816-7529
(401) 304-7015
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN79645
RI
Other
Enumeration date
07/10/2024
Last updated
07/10/2024
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