Individual
MALLORY SOUSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
681 RESERVOIR AVE, CRANSTON, RI 02910-3220
(401) 943-7186
Mailing address
681 RESERVOIR AVE, CRANSTON, RI 02910-3220
(401) 943-7186
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN04134
RI
Other
Enumeration date
07/24/2024
Last updated
03/24/2026
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