Organization
WELLNESS CONNECT GO BEYOND MEDICINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIRIANNYS RIVAS FNP-C (FNP-C)
(401) 642-0100
Entity
Organization
Contact information
Practice address
655 BROAD ST STE 201, PROVIDENCE, RI 02907-1444
(401) 642-0100
(833) 992-2318
Mailing address
655 BROAD ST STE 201, PROVIDENCE, RI 02907-1444
(401) 642-0100
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207VG0400X
Gynecology Physician
—
—
251E00000X
Home Health Agency
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
09/04/2019
Last updated
01/24/2024
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