Individual
MARY CATHERINE POLK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
1698 MAIN RD, TIVERTON, RI 02878
(508) 472-1103
(800) 506-1624
Mailing address
1698 MAIN RD, TIVERTON, RI 02878-4518
(508) 472-1103
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
S52455
MA
Other
Enumeration date
04/28/2006
Last updated
05/28/2021
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