Individual
KENNETH RALPH VIEIRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CNP
Contact information
Practice address
180 CORLISS ST STE C, PROVIDENCE, RI 02904-2602
(401) 793-4636
Mailing address
117 ELLENFIELD ST STE 101, PROVIDENCE, RI 02905-4541
(401) 444-6779
(401) 444-6912
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN2321336
MA
363L00000X
Nurse Practitioner
Primary
APRN03921
RI
363L00000X
Nurse Practitioner
RN2321336
MA
Other
Enumeration date
12/06/2023
Last updated
03/08/2024
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