Individual
MARIE MARGUERITE SAMPLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
18 IMPERIAL PL UNIT 2D, PROVIDENCE, RI 02903-4642
(401) 727-4800
Mailing address
455 TOLL GATE RD, WARWICK, RI 02886-2759
(401) 273-0641
(401) 273-2919
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
30769
SC
367A00000X
Advanced Practice Midwife
11987
TN
367A00000X
Advanced Practice Midwife
CNM00178
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
582369659
PRIVATE INS COMPANIES
GA
05
—
726695410A
—
GA
Enumeration date
08/23/2006
Last updated
05/04/2026
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