Individual
JASON LORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1020 PARK AVE, CRANSTON, RI 02910-3227
(401) 396-7649
Mailing address
20335 PATRIOT WAY, WEST GREENWICH, RI 02817-6027
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN03515
RI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
APRN04537
RI
Other
Enumeration date
07/31/2023
Last updated
12/22/2025
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