Individual
CRYSTAL LISE SOUZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
450 CLINTON ST, WOONSOCKET, RI 02895-3207
(401) 767-4100
Mailing address
450 CLINTON ST, WOONSOCKET, RI 02895-3207
(401) 767-4100
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
10730
CT
363LF0000X
Family Nurse Practitioner
Primary
APRN00778
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1467826693
—
RI
Enumeration date
11/27/2015
Last updated
08/25/2025
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