Individual
STACY NADINE HALTAUFDERHYDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
475 KILVERT ST, WARWICK, RI 02886-1379
(401) 732-7406
Mailing address
475 KILVERT ST, WARWICK, RI 02886-1379
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APN01730
RI
Other
Enumeration date
02/28/2018
Last updated
02/28/2018
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