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Individual

KELLY ANN BURNISTON GODIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
530 N MAIN ST, PROVIDENCE, RI 02904-5762
(401) 228-6812
(401) 383-8163
Mailing address
530 N MAIN ST, PROVIDENCE, RI 02904-5762
(401) 228-6812
(401) 383-8163

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
163W00000X
RI

Other

Enumeration date
09/10/2019
Last updated
09/10/2019
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